Ghatkopar (East), Mumbai)
Home > Plastic & Reconstructive Surgery > Cleft Repair Surgery
Cleft Repair Surgery In Mumbai
Expert Surgical Correction of Cleft Lip and Cleft Palate for Infants and Children at Shree Hospitals
A cleft lip and cleft palate are among the most common congenital birth defects, occurring when the lip or the roof of the mouth fails to fuse completely during early fetal development. At Shree Hospitals, our specialist cleft surgery team - including plastic surgeons, paediatric surgeons, orthodontists, speech therapists, and ENT surgeons - provides comprehensive cleft repair from infancy through adolescence, following internationally recognised cleft care protocols to restore normal appearance, speech, feeding, and dental development.
Newborn with Cleft Lip or Palate? Consult Our Cleft Surgery Team at Shree Hospitals
Quick facts
Condition: Cleft Lip, Cleft Palate, or Combined Cleft Lip and Palate
Age of Repair: Cleft Lip: 3 to 6 months / Cleft Palate: 9 to 12 months
Anaesthesia: General Anaesthesia (paediatric anaesthetist)
Duration: 1.5 to 3 hours per procedure
Hospital Stay: 2 to 5 days
Support Team: Plastic surgeons, speech therapists, orthodontists, ENT surgeons
Key Benefit: Reliable reconstruction with vascularised living tissue
What is Cleft Repair Surgery?
A cleft lip is a split or opening in the upper lip that can range from a small notch at the lip border to a wide gap extending into the nose. A cleft palate is an opening in the roof of the mouth (palate) that occurs when the two sides of the palate fail to join during fetal development between weeks 6 and 12 of pregnancy. Cleft lip and cleft palate can occur separately or together. They can be unilateral (one side) or bilateral (both sides). Both conditions affect feeding, speech development, hearing, dental development, and facial appearance, and require surgical correction as part of a comprehensive multi-stage cleft care programme delivered by a specialist multidisciplinary team.
Cleft lip repair (cheiloplasty) is typically performed at 3 to 6 months of age once the baby has gained sufficient weight and is medically stable. The procedure recreates the normal anatomy of the lip - restoring the Cupid's bow, the philtrum columns, and the nostril base - using precise techniques such as the Millard rotation-advancement repair (for unilateral cleft lip) or the Mulliken repair (for bilateral cleft lip). Cleft palate repair (palatoplasty) is performed at 9 to 12 months of age - before the child begins developing speech - to restore the structural integrity of the palate and allow normal speech development. Techniques include the von Langenbeck palatoplasty, the Furlow double-opposing Z-plasty, and the two-flap Bardach palatoplasty.
At Shree Hospitals, cleft care is delivered through a structured multi-stage protocol that begins at birth with pre-surgical preparation (nasoalveolar moulding) and continues through lip repair, palate repair, alveolar bone grafting (at age 8 to 10), orthodontic treatment, speech therapy, rhinoplasty (at skeletal maturity), and revision surgery as needed. Our multidisciplinary cleft team meets regularly to review each patient's progress and plan the next stage of care, ensuring every child with a cleft receives comprehensive, coordinated treatment from birth to adulthood.
Who Needs Cleft Repair Surgery?
Cleft repair surgery is indicated for:
- Newborns and infants diagnosed with cleft lip, cleft palate, or combined cleft lip and palate (diagnosed prenatally on ultrasound or at birth)
- Children with feeding difficulties due to cleft palate (inability to create negative oral pressure for suckling)
- Children at risk of speech delay and velopharyngeal insufficiency (VPI) if palate repair is delayed beyond 18 months
- Children with recurrent otitis media associated with Eustachian tube dysfunction secondary to cleft palate
- Children requiring alveolar bone grafting at 8 to 10 years to allow eruption of the canine tooth into the cleft site
- Adolescents and adults with residual cleft deformity requiring cleft rhinoplasty, lip revision, or orthognathic surgery
Is Cleft Repair Surgery Right for Your Child?
Cleft surgery is recommended when:
- The diagnosis of cleft lip or cleft palate has been confirmed clinically (and prenatally by fetal ultrasound or MRI where indicated)
- The child meets the weight and medical fitness criteria for general anaesthesia (typically greater than 5kg for lip repair)
- A paediatric anaesthetist experienced in airway management in children with cleft has reviewed the case
- Pre-surgical nasoalveolar moulding (NAM) has been completed where appropriate (for wide bilateral clefts) to reduce gap width before surgical repair
- The family has been counselled about the multi-stage nature of cleft care and the expected outcomes at each stage
Why Timely Cleft Surgery Changes a Child's Life?
Early, staged cleft repair is critical for:
- Feeding: Cleft palate prevents babies from generating suction for breastfeeding. Early repair (and specialist feeding support before repair) prevents nutritional failure
- Speech development: Palate repair before 12 months gives the child a structural foundation for normal speech development. Late repair leads to established compensatory articulation errors that are harder to correct
- Hearing: Cleft palate causes Eustachian tube dysfunction leading to glue ear and hearing loss that impacts language acquisition
- Dental development: Alveolar bone grafting at 8 to 10 years provides bone for the permanent canine tooth to erupt normally
- Psychosocial wellbeing: Restoring normal appearance before school age significantly reduces the social and psychological impact of the cleft deformity
Cleft repair at Shree Hospitals delivers excellent long-term outcomes in speech, feeding, appearance, and dental development for every child.
Our multidisciplinary cleft team at Shree Hospitals follows internationally recognised cleft care protocols from birth through adulthood, combining expert cleft lip and palate surgery with speech therapy, orthodontics, and ENT care to give every child the best possible start in life.
24×7 Emergency Care
Our Approach to Cleft Repair Surgery
At Shree Hospitals, cleft care is a lifelong commitment. We manage every child with a cleft as a member of our cleft team from birth through skeletal maturity, with regular multidisciplinary reviews, staged surgical interventions, and coordinated therapy at every developmental stage.
24×7 Emergency Care
Pre-Surgical Preparation and Parental Counselling
Families of children with a cleft receive comprehensive counselling immediately after birth (or at the prenatal diagnosis stage for prenatally diagnosed clefts). Our cleft nurse specialist and plastic surgeon counsel parents on feeding techniques (specialist cleft feeding bottles such as the Haberman or Pigeon feeder for palate clefts), growth monitoring, and the planned surgical timeline. For wide unilateral or bilateral cleft lips, nasoalveolar moulding .
Precise Cleft Lip and Nose Repair Cleft lip repair
At Shree Hospitals is performed at 3 to 6 months of age using the Millard rotation-advancement technique for unilateral cleft lip or the Mulliken bilateral technique for bilateral cases. Our surgeons restore the natural anatomy of the lip including the orbicularis oris muscle (which must be repaired deep to the skin for a functional and aesthetically natural repair), the philtrum, the Cupid's bow, and the nasal base.
Cleft Palate Repair and Speech Optimisation Cleft palate repair
At Shree Hospitals is performed at 9 to 12 months of age using the Furlow double-opposing Z-plasty (preferred for better speech outcomes, particularly in soft palate clefts) or the Bardach two-flap palatoplasty (for wider palate defects). The critical goal of palatoplasty is to lengthen the soft palate and reconstruct the levator veli palatini muscle sling that enables the palate to close against the back wall of the throat during speech - a function called velopharyngeal closure.
Long-Term Care, Alveolar Grafting, and Revision Surgery
Cleft care continues well beyond infancy. At 8 to 10 years (before the permanent canine tooth erupts), alveolar bone grafting - placing a cancellous bone graft (usually from the hip) into the alveolar cleft in the gum ridge - closes the gap in the dental arch and provides bone for tooth eruption and orthodontic movement. Orthodontic treatment manages tooth alignment before and after bone grafting. At skeletal maturity (16 to 18 years), cleft rhinoplasty corrects the residual nasal asymmetry associated with the cleft.
Top Plastic and Reconstructive Surgeons in Mumbai
We offer a comprehensive range of plastic and reconstructive surgery procedures including cleft repair, skin grafting, flap surgery, microsurgery, breast reconstruction, scar revision, wound debridement, and functional rhinoplasty, all delivered by specialist plastic surgeons.
24×7 Emergency Care
Dr. Suyash Yashwant Patankar
Consultant Plastic, Reconstructive
Dr. Arun V. Sheth
Consultant Plastic, Cosmetic
Dr. Abhijeet Dharmaji Sawant
Consultant Plastic, Reconstructive, Aesthetic
Dr. Udit Dalmia
Consultant Plastic, Aesthetic
Plastic and Reconstructive Surgery Services At Shree Hospitals
We offer a comprehensive range of plastic and reconstructive surgery procedures including flap surgery, skin grafting, microsurgery, breast reconstruction, cleft repair, scar revision, wound debridement, and functional rhinoplasty, all delivered by specialist plastic and microsurgeons.
.
Step by Step Process of Cleft Repair Surgery at Shree Hospitals
Step 1 - Diagnosis and Initial Assessment
At birth (or at the prenatal diagnosis stage), the cleft surgeon and cleft team meet with the family to explain the diagnosis, the planned treatment timeline, and what to expect at each stage. Photographs are taken to document the cleft type and severity. Feeding assessment is performed by the cleft nurse specialist and appropriate specialist feeding equipment is provided. ENT assessment with hearing tests (ABR) is arranged for infants with cleft palate to detect glue ear early. Dental and orthodontic baseline assessment is recorded.
Step 2 - Pre-Surgical Nasoalveolar Moulding (Where Indicated)
For wide or bilateral cleft lips, NAM therapy begins in the neonatal period (ideally within the first 2 weeks of life). Custom-made intraoral appliances gradually reshape the alveolar segments and nasal cartilages over 2 to 4 months, reducing cleft gap width and improving the position of the nasal tip and columella before surgery. This reduces surgical tension at repair and improves long-term nasal symmetry.
Step 3 - Cleft Lip Repair (3 to 6 Months)
Under general anaesthesia (administered by a paediatric anaesthetist), the cleft lip is repaired using the planned technique. The orbicularis oris muscle is dissected and repaired in layers to create a functional lip sphincter. The skin is closed with fine absorbable sutures to minimise scarring. Primary nasal correction is performed simultaneously. The procedure takes 1.5 to 2.5 hours. The child is monitored post-operatively and discharged within 2 to 3 days once feeding is re-established.
Step 4 - Cleft Palate Repair (9 to 12 Months)
The cleft palate is repaired under general anaesthesia using the planned palatoplasty technique. The levator veli palatini muscles are dissected from the hard palate edges and re-united across the midline to create a functioning soft palate muscle sling. The palate is closed in three layers. The child is kept in hospital for 3 to 5 days post-operatively and maintained on a soft or liquid diet for 4 weeks. Speech therapy assessment commences at 18 months to monitor speech development.
Step 5 - Alveolar Bone Grafting (8 to 10 Years)
At the appropriate dental development stage (confirmed by dental panoramic X-ray showing the developing permanent canine root), cancellous bone graft is harvested from the child's iliac crest and packed into the alveolar cleft. This provides bone for the permanent canine to erupt through and allows closure of the residual fistula in the gum line. Orthodontic treatment is coordinated before and after grafting to align the teeth into the newly grafted bone.
Step 6 - Revision Surgery and Rhinoplasty at Skeletal Maturity
At 16 to 18 years (once facial growth is complete), cleft rhinoplasty is performed to correct residual nasal asymmetry, reconstruct the nasal tip cartilages, and improve the columella and alar base symmetry. Lip revision is offered where residual lip scar asymmetry or vermilion deficiency is present. Orthognathic surgery is planned by the surgical team and orthodontist together for cases with significant jaw discrepancy affecting bite and facial profile
Patient Questions About Cleft Repair Surgery
When should my child have cleft lip and palate surgery?
The internationally recommended timing is cleft lip repair at 3 to 6 months of age (once the baby weighs at least 5kg and is medically fit for anaesthesia) and cleft palate repair at 9 to 12 months of age (before the critical window for speech development). Palate repair should be completed before the child begins developing speech sounds (ideally before 12 months) to give the best chance of normal speech. Later repair leads to established abnormal speech patterns that are more difficult to correct with speech therapy alone. Our cleft team will advise on the precise timing for your child based on their individual development and weight gain.
Will my child's cleft lip scar be visible when they are older?
All cleft lip repairs leave a scar, but with modern surgical techniques the scar is placed within the natural skin creases of the upper lip (along the philtrum column) where it fades to become much less noticeable over time. Most children who have had a cleft lip repair by an experienced surgeon have a scar that is subtle by the time they reach school age. Scar management with silicone gel and sun protection is recommended for 12 months post-operatively to optimise scar appearance. Scar revision surgery can further improve the scar at a later stage if needed. Our surgeons use the finest sutures and meticulous technique to minimise scar visibility
Will my child speak normally after cleft palate repair?
The majority of children who have cleft palate repair within the first 12 months of life go on to develop normal or near-normal speech with the support of speech therapy. Approximately 20 to 25% of children who have had palate repair develop some degree of velopharyngeal insufficiency (VPI) - a condition in which the repaired palate does not close fully against the back of the throat during speech, causing nasal air escape and a hypernasal voice quality. VPI is assessed by the speech therapist using nasendoscopy and speech analysis, and can be treated with pharyngoplasty or pharyngeal flap surgery if required. Speech therapy from 18 months onwards is a key part of the care programme for all children with cleft palate.
Does cleft repair surgery carry risks?
As with all surgical procedures under general anaesthesia, cleft repair surgery carries risks, but serious complications are uncommon when performed by an experienced team. Specific risks include bleeding during or after surgery, wound infection or wound breakdown (which can occur in 5 to 10% of palate repairs and usually heals with conservative management), fistula formation (a small hole in the repaired palate, requiring revision surgery), and anaesthetic risks (managed by a paediatric anaesthetist experienced in cleft airway management). The risks of not operating - including severe feeding difficulties, permanent speech impairment, hearing loss, and dental developmental problems - far outweigh the surgical risks of timely cleft repair.
Evidence-Based Case Studies by Our Specialists
Would Recommend Us
"When our son was diagnosed before birth we were frightened. The cleft team at Shree Hospitals guided us from day one - the moulding device, the feeding support, each surgery at the right time. By age three our son was speaking normally. The team gave him a wonderful start."
Mr. Arjun P.
"Our daughter had only a palate cleft which was harder to see but caused real feeding problems. After the operation at Shree Hospitals she fed better immediately. Her speech is wonderful now and nobody would know she had a cleft."
Miss Ria S.
"I grew up in a rural area and never had the surgery as a child. When I came to Shree Hospitals as an adult the team were very kind and performed the revision surgery. The result changed my life - I look and feel like myself for the first time."
Ms. Kavitha R.
Patient
Resources
Schedule consultation
Billing & Payments
Health Packages
Hospital Facilities
24×7 Emergency Care
1800-268-4000
News & Updates
Shree Hospitals is the first to perform robotic endo surgery.
Shree Hospitals Introduces Advanced Robotic Surgery for Better Patient Care
Shree Hospitals Expands Advanced Surgical Care With Latest Medical Technology
Health Center
Exploring the Future of Telemedicine: What’s Next for Healthcare?
The Rise of Renewable Energy: Innovations in Sustainability
Follow Us
Shree
Hospitals
Shree
Hospitals
