Dr Shraddha Deshpande

Smile Surgery

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Cleft lip or cleft palate is a birth defect. During pregnancy, as baby features develop, two halves of the lips sometimes don’t gel properly, leaving an opening called ‘cleft’. It can also happen to the roof of mouth called as palate. As various body features develop separately but simultaneously, a baby can have either cleft lip or cleft palate or both. As one can imagine, cleft lip or cleft palate not only appears different, it causes difficulty in feeding/eating & it can potentially make speaking difficult for the child.

A surgery to repair cleft lip and/or cleft palate is often called smile surgery as it not only improves appearance but also helps in speech development.

Patients with cleft lip or cleft palate require a multi-disciplinary approach right from the child’s birth including paediatrician, prosthodontist, speech therapist, orthodontist and nutritionist. Cleft lip -palate repair is a complex ongoing process which requires multiple surgeries at various stages. The initial surgery is generally done with the child is at least 3 months’ old for cleft lip and at least 9 months’ old for cleft palate. In certain cases both surgeries can be done at the same time. Depending on the severity of cleft, the child will need a scar revision surgery, alveolar bone grafting surgery and cleft rhinoplasty surgery at a later stage.


Surgery to correct cleft lip and/or cleft palate is usually done before child turns 12 months old. It also depends on health of child, extent of the cleft etc. This surgery is performed under general anesthesia & it takes anywhere between 2 to 3 hours. The procedure requires overnight stay in hospital. 


Cleft lip and/or cleft palate surgery will help achieve following.

  • More normal looking facial/mouth area
  • Improved ability of eating and speaking

What about scars?

Scars are an inevitable part of any invasive surgery. Your surgeon will endeavor to minimize scarring. Scars usually fade with time and become barely noticeable. Please discuss about scars with your surgeon.

Risks/ Complications

Surgery to repair cleft lip or cleft palate is generally safe. If the surgery is done for cleft palate, closing the palate (so that child can eat and speak properly) takes precedence over the appearance. Following potential complaints, risks and complications may occur during cleft lip or cleft palate procedure.

  • Asymmetry – one side of lip or mouth does not match with other
  • Infection (infection of ear is also possible)
  • Bleeding
  • Bruising, swelling & pain
  • Nausea
  • Numbness

In rare case, as with all surgical procedures, a revision surgery may be necessary to correct minor irregularities.

Care after treatment/ surgery

Immediately following surgery, your surgeon will use bandages to cover the wound which will support natural healing process, minimize bruising and swelling. As one can imagine, eating/feeding could be a challenge and your surgeon will recommend ways to feed the child and may occasionally use intravenous line to maintain fluid levels in body. Your surgeon may also advise restraints for some days so that child does not scratch the wound or pull the bandage out.

Parents play an important role in post-surgery healing process and it is important to follow surgeon’s instructions for quicker recovery and healing.


Costs for individual procedures will vary widely based on the procedure & hospital chosen for surgery but usually involves following.

  • Surgeon’s fee
  • Hospital facility charges
  • Anesthesia fees
  • Medical tests & medicines

If revision surgery is needed in a rare case, your surgeon will not charge Surgeon’s fee but other costs will have to be borne by patient as applicable. 

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