Our board-certified oral and maxillofacial surgeons provide compassionate, specialized surgical care for children with Cleft Lip and Palate conditions, helping young patients across the Denver Metro area achieve their best functional and aesthetic outcomes.
Overview
What is Cleft Lip and Palate?
A Cleft Lip is a separation in the upper lip that occurs during early facial development, while a Cleft Palate is an opening in the roof of the mouth. They can occur individually or together and vary in severity from child to child. While these conditions are present at birth, surgical treatment is typically staged across childhood and into adolescence, with each procedure carefully timed to support your child's growth, development, speech, and overall quality of life. Our oral and maxillofacial surgeons work as part of a coordinated care approach, collaborating with your child's broader medical and dental team to ensure every stage of treatment is thoughtfully planned and expertly executed.
When does a child need surgery?
Cleft Lip and Palate conditions require a series of surgical procedures timed to key stages of your child's development. Earlier procedures address the structural separation and support normal feeding, speech development, and facial growth. As your child grows, additional surgeries may be recommended to refine appearance, correct bite alignment, rebuild bone structure in the upper jaw through Bone Grafting, or address breathing and airway concerns. Our surgeons evaluate each child individually, using advanced imaging and close coordination with your care team to develop a treatment plan that fits your child's specific anatomy, timeline, and goals.
Benefits of surgical Cleft Lip and Palate treatment
- Restores normal lip and palate structure to support speech and function
- Improves feeding, breathing, and airway development
- Supports healthy facial growth and bone development over time
- Addresses bone deficiencies in the upper jaw through Bone Grafting
- Coordinates with orthodontic and dental treatment for long-term outcomes
- Delivered by board-certified oral and maxillofacial surgeons with direct experience in craniofacial care
From prep to recovery, you’re in good hands.
Before surgery
Understanding the condition & initial evaluation
Cleft Lip and Cleft Palate are among the most common birth defects, occurring when developing facial structures do not fuse completely during early pregnancy. Since the lip and palate develop separately, a child may be born with a Cleft Lip, a Cleft Palate, or both. If left untreated, these conditions can affect eating, speech, hearing, dental development, and psychological well-being.
Care for Cleft Lip and Palate requires a coordinated team of specialists, including your oral and maxillofacial surgeon, a plastic surgeon, a pediatric dentist, an orthodontist, and other providers as needed. Our role is to help restore the jaw and facial structures, supporting normal function and appearance across multiple stages of your child's development.
Surgical timeline overview
Treatment is staged according to your child's age and development:
- Cleft Lip Repair: Typically performed at around 10–12 weeks of age. The goal is to close the separation, restore muscle function, and create a more natural lip and nose shape.
- Cleft Palate Repair: Typically performed between 7 and 18 months of age. Surgery closes the opening in the roof of the mouth and repositions the muscles of the soft palate to support proper speech development.
- Alveolar Bone Grafting: Usually performed between ages 7 and 9, during the mixed dentition phase, before the permanent canine tooth erupts. A bone graft is placed to restore the gum ridge, support permanent teeth, and close any remaining gaps between the nose and mouth.
- Secondary and revision procedures: Additional surgeries for scar revision, nasal refinement, jaw advancement (if needed), or other improvements may be recommended in the teenage years or early adulthood.
Pre-surgical preparation
Before each procedure, our team will:
- Review your child's full medical history and any prior treatments.
- Take 3D imaging and X-rays as needed to guide surgical planning.
- Coordinate with your child's orthodontist before Alveolar Bone Grafting — orthodontic expansion of the upper arch is often completed 6–9 months before grafting to create the proper space.
- Provide detailed fasting instructions (generally nothing by mouth for 6–8 hours before surgery under General Anesthesia) and pre-operative care guidelines.
During surgery
Cleft Lip Repair
Cleft Lip Repair surgery is performed under General Anesthesia and typically takes less than two hours. Incisions are made on either side of the Cleft to create tissue flaps that are repositioned and sutured with absorbable stitches, restoring the natural contour and function of the lip. If the nostril is affected, initial reshaping can often be addressed during the same procedure.
Cleft Palate Repair
Cleft Palate Repair surgery is also performed under General Anesthesia. The surgeon closes the opening in the roof of the mouth by rearranging and repositioning the muscles and tissue of the palate. Dissolvable sutures are used, and the procedure is designed to support normal speech and swallowing development.
Alveolar Bone Grafting
Alveolar Bone Grafting is performed under General Anesthesia. Bone — typically harvested from the hip (iliac crest) or another donor site — is transplanted into the Cleft of the gum ridge (alveolus). This restores the continuity of the jaw, provides support for the permanent teeth near the Cleft, and closes any remaining gap between the oral and nasal cavities.
After surgery
Cleft Lip & Palate Repair recovery
- Your child will typically spend one night in the hospital after lip or palate surgery to ensure they are recovering well.
- Liquid or soft foods only are required for the initial healing period. Feeding instructions will be tailored to your child's age and procedure.
- Arm restraints (no-no sleeves) may be used temporarily to prevent small children from placing hands or objects in the mouth.
- Dissolvable sutures do not need to be removed, but the surgical site should be kept clean per our instructions.
- Swelling, minor bruising, and mild discomfort are expected and manageable with prescribed medication.
Alveolar Bone Graft recovery
- Light activity is recommended for the first 2 weeks. Avoid anything hard, sharp, or rough in the mouth.
- A soft or liquid diet is required for several days as the graft begins to integrate.
- Follow-up X-rays with the orthodontist approximately 3 months after surgery will confirm whether the bone graft was successful.
- Once healed, orthodontic treatment can resume or continue to guide permanent tooth eruption into the grafted area.
When to contact us
- Fever that develops after surgery.
- Significant bleeding that does not slow with gentle pressure.
- Opening of the surgical repair (a gap or fistula forming in the palate or lip).
- Difficulty swallowing, breathing, or unusual behavior in young children following surgery.
If your child has been referred for Cleft Lip and Palate Surgery or you are seeking a consultation, our team is here to guide your family through every step. Contact us at any of our three Denver Metro locations in Englewood, Littleton, or Aurora.
Your questions, answered.
Advanced Oral & Maxillofacial Surgery is here to address all your questions and concerns regarding Cleft Lip and Palate.
How common is Cleft Lip and Palate?
Cleft Lip and Palate is one of the most common birth defects, occurring in approximately 1 in every 800 babies. It is more common in some ethnic populations and can occur as an isolated condition or as part of a broader syndrome.
When is the best age for each surgery?
Cleft Lip Repair is typically performed around 10–12 weeks; Cleft Palate Repair between 7 and 18 months; and Alveolar Bone Grafting most often between ages 7 and 9, before the permanent canine tooth erupts. Timing is personalized to each child's development and overall health.
What is a fistula, and what happens if one develops?
A fistula is a small hole or opening that can occasionally form in the repaired palate. If small, it may cause only minor fluid leakage into the nose. Larger fistulas can affect eating and speech and may require additional surgery to close. We monitor for this during follow-up appointments.
Will the scars from surgery be visible?
Some scarring is inevitable, but our surgeons use precise techniques to minimize visibility. Lip repair scars generally fade significantly over time and are positioned along natural contours of the Lip. Palate and bone graft incisions are entirely inside the mouth. Scar revision procedures can be performed later in childhood or adolescence if needed.
Will my child need multiple surgeries?
Yes. A child with a Cleft Lip and/or Palate can expect a series of staged procedures over the first 18 or more years of life. The exact treatment plan depends on the type and severity of the Cleft. Your care team will provide a detailed roadmap at each stage so you know what to expect and when.
Will my child's speech be affected?
With timely palate repair and appropriate speech therapy, most children with Cleft Palate develop normal or near-normal speech. A small percentage may require additional procedures if the repaired palate does not function fully. Your care team will monitor speech development and recommend early intervention if needed.
Where does the bone come from for Alveolar Bone Grafting?
The bone is most commonly taken from the hip (iliac crest), though other donor sites such as the chin or tibia may be used depending on the child's size and anatomy. The harvest site is typically sore for a week or two but heals well. We will discuss the planned donor site with you before surgery.
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Take the first step towards a healthier, more confident smile. Our team is here to answer your questions and guide you through a comfortable and effective treatment journey.
