Reconstruction - Craniofacial

Cleft Lip and Palate

The UCLA Craniofacial Clinic, one of the largest centers in the US, provides consultative and surgical treatment for patients with craniofacial abnormalities.

One in 400 to 600 infants are born with a cleft lip and/or palate deformity (unilateral cleft lip, bilateral cleft lip or in combination with a cleft palate, or cleft palate alone). The UCLA Craniofacial Center has a team of specialists dedicated to the treatment of cleft patients from in infancy to maturity.

During a visit to the Center, patients are evaluated by craniofacial surgeons, pediatricians, geneticists, orthodontists, pediatric dentists, speech pathologists, neurosurgeons, otolaryngologists, oral surgeons, otologists, psychiatrists, ophthalmologists and social workers.

Our team of internationally recognized experts provide state-of-the-art treatment for children with craniofacial birth defects. UCLA Medical Center, which includes Mattel Children's Hospital at UCLA, is rated as one of the top five hospitals in the United States and the best hospital in the western United States in US News & World Report's Annual Best Hospitals Survey.

Before	After
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The UCLA Pediatric Plastic Surgery Team is internationally recognized for its commitment and quality and has one of the most longstanding track records in the world.

UCLA School of Dentistry, which works intimately with the plastic surgery team, is ranked as one of the top five in the United States and is the only US dental school with clinics dedicated to children with complex facial birth defects.

Before	After
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Together, the team of specialists will form a treatment plan, which will be presented to the patient, family and referring healthcare provider.

Surgical time course (may vary):

1. Antenatal consultation (before birth) is provided for parents who receive an in utero diagnosis of a clefting problem to relieve anxiety and provide necessary information.
2. After birth, a presurgical nasoalveolar molding (PNAM) device is fashioned by the prostodontal member of the team. (Please see patient image on the right). This helps bring the gum line together and improves nasal shape.
3. At 3 months of age repair of the cleft lip and nose deformity is performed by the plastic surgeon.
4. At 10 to 14 months of age the cleft palate is repaired. Ear tubes (myringotomy tubes) may also be placed at this time by the otolaryngologist (ENT).
5. Prior to school age, cleft lip scar revision or nasal revision may be performed to optimize appearance.
6. Speech is monitored closely in yearly visits. In approximately 15 percent of patients, a second palatal surgery (pharyngeoplasty or pharyngeal flap) is necessary.
7. After permanent molars erupt (age 6-8 years) orthodontic expansion is performed. A bone graft from the hip to the space in the alveolar ridge (gum line) is then placed.
8. In the teenage years patients require orthodontics and may require an upper jaw advancement (Le Fort I orthagnathic procedure) if jaw growth lags behind.
9. As a final stage, correction of nasal deviation with a septorhinoplasty is performed.
10. Since each patient is unique, the necessity of procedures will depend on discussions among the UCLA Craniofacial team, patient and family.

Call our toll free number 1-866-233-2176