Every parent and doctor of a child with cleft lip hopes that a single surgery will solve the cleft lip problem, but the reality is not as good as it should be. With the exception of a few children who are well enough to have a single surgery to solve the problem, most require a second surgery or even multiple surgeries. Even if the first surgery is beautiful, over time, nasolabial deficiencies such as upward shift of the lip peak, red lip depression, nasal collapse, nasal column tilt, scar growth, etc. tend to gradually appear, and these deformities need a second surgery to be resolved.
Common reasons why children with cleft lip need second-stage surgery 1. The child is young at the time of initial surgery, and some anatomical landmarks such as the human mid-arm are not yet obvious.
2.Surgical methods have limitations, no surgical solution is perfect and its shortcomings will be gradually exposed over time.
3. Postoperative tissue growth and development on the affected side is not coordinated with that on the healthy side, making the local deformity more obvious.
4.Children with cleft lip may also have deformities such as cleft palate, cleft alveolus, and underdeveloped jaw bone, and the deficiency of bone tissue makes the deformity of the nose and lip more obvious.
5.The contraction and pulling of the local scar is also an important cause of deformity.
6.Wound erosion, infection or even splitting after the first surgery can leave obvious scarring.
Common indications for second-stage cleft lip repair surgery 1, correction of nasal deformity, such as nasal wing collapse, nasal base depression, nasal tip flattening, nasal base overwidth, etc.; 2, correction of upper lip deformity, such as lip scar, lip peak upward shift, lip peak separation, etc.; 3, upper lip orbicularis muscle abnormalities such as skin depression, etc.; 4, front lip too short or too wide; 5, lip red deformity such as lip red hypertrophy, depression deformity, etc.; timing of second stage cleft lip repair surgery
The timing of second-stage surgery depends on the deformity of the child. Generally speaking, if the deformity is obvious, it can be performed before school age, such as before going to kindergarten or elementary school. This is when the child’s sense of self begins to form and the improvement in appearance is beneficial to the child’s psychological development. However, early surgery may be required for the aforementioned reasons, such as growth and development, and the deformity may reappear. If the deformity is not obvious, the surgery can be performed after the child’s development is completed, such as when he or she is a teenager, when the deformity is already fixed and the surgery can be more thorough and better compensate for the regret left after the first stage surgery.