Cleft Lip Surgery - Postoperative Instructions

Cleft lip is one of the most common and one of the most correctable birth defects. Surgery is required to close the gap in the upper lip.

Our skilled plastic surgeon and the surgical team at Golisano Children's Hospital will do its best to ensure your child's comfort and safety, as well as your peace of mind during the procedure. Often, it helps to know what to expect following surgery.

What to Expect

General

• For a week or two after surgery, your child may need extra attention and understanding. Don’t worry about “spoiling” your child during this time. It is OK to respond to your child’s need for extra holding and comforting.
• After surgery, your child will be sleepy for several hours. Your child will have an IV in place for giving fluids and pain medicines. The lip and nose will be swollen. You may see a little bloody drainage around the lips and nose. You may see stitches on the lip and under the nose.

Feeding

• Your child’s lip is repaired with dissolving sutures that will not need to be removed, but the repair is delicate for several months after surgery.
  • Give your child his or her usual diet at home.
  • Avoid pressure on the lip stitches with the nipple or feeder.
  • If you are breastfeeding, your child may breastfeed as usual after surgery. You can also use a soft-tip spoon, sippy cup or bottle.
• Sometimes your child's nose may get stuffy. This will make it difficult for your child to eat. Clear the nose with normal saline nose drops. You can buy saline nose drops in any drug store. If the nose drops don't clear your child's nose, use a nasal aspirator or bulb syringe. This must be done very gently.

Activity

• Generally, most children are ready to return to daycare about 2 weeks after surgery. If you have concerns or questions about when your child can return, please discuss this with us.

Pain

• Your child may have some mild discomfort at home. If your infant is irritable and not feeding well, he or she may be in pain. Give acetaminophen (Tylenol®), as directed by your child’s doctor. Acetaminophen comes as a tablet, caplet, and liquid. It is used to relieve mild to moderate pain and to reduce fever. It is important to take acetaminophen exactly as directed by your doctor. Follow the directions on the package and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it than prescribed by your doctor. Do not take it any more often than prescribed by your doctor.
• If your child has more than mild discomfort, the doctor may prescribe medicine to help ease the pain. Give pain medicine as prescribed and instructed by your doctor and nurse.
• Try to schedule a dose of pain medicine around bedtime, especially for the first few days at home. This will help your child sleep better.

Constipation

• Keep track of your child’s bowel habits. He or she should return to previous bowel habits. If not, he or she may be constipated.
• Call your child’s pediatrician or the Plastic Surgery team if you think your child is constipated.

Skin and Wound Care

• The incision is closed with absorbable sutures that won’t need to be removed. On top of the sutures, the surgeon will place a layer of skin glue (Dermabond). No wound care is needed, and the skin glue will fall off on its own, usually within 2 weeks.
• You can bathe your child in the tub. The lip can get wet, but do not scrub the area.

Follow-up

• Please make a clinic appointment for 2 weeks after surgery.
• After this visit, you will likely be seen again in about 2 months.
• When to call your child’s doctor or nurse

If your child:

• has redness, increased swelling, drainage, or bleeding from the lip incision;
• has separation of the suture line;
• has a fever higher than 101.5°F degrees;
• has pain that doesn't get better after pain medicine is given;
• is not drinking liquids or is vomiting;
• has trouble breathing.

If you have any questions or concerns, call the office at (585)-275-1000 and someone will assist you.