Name of the Procedure:

Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure, also known as Bilateral Primary Cleft Lip Repair or Bilateral Cleft Lip and Nasal Deformity Correction.

Summary

This procedure involves surgical correction of a cleft lip and associated nasal deformities in patients with bilateral cleft lip. It is conducted in one stage, meaning the repair is completed in a single surgical session.

Purpose

This surgery treats bilateral cleft lip and nasal deformities. The goals are to close the lip gap, create a more natural lip shape, improve nasal structure, and enhance both functional and aesthetic aspects of the patient's face.

Indications

The procedure is recommended for patients with a congenital bilateral cleft lip and potential nasal deformities. Indications include difficulty in feeding, speech impediments, and facial aesthetic concerns. Ideal candidates are typically infants or young children to allow for normal facial development.

Preparation

• Patients, usually infants, should fast for several hours before the procedure.
• A thorough medical evaluation, including blood tests and imaging studies, may be required.
• Pediatricians and surgeons will assess the child’s overall health to confirm readiness for surgery.

Procedure Description

• The surgery begins with the administration of general anesthesia.
• Surgeons make precise incisions around the cleft areas.
• Tissue flaps from both sides of the lip and nasal structures are carefully repositioned and sutured to form a natural lip and nasal contour.
• Surgeons may use specialized tools such as surgical scissors, scalpels, and suturing equipment.
• Nasal stents or sutures might be placed to support the nasal structure during healing.

Duration

The procedure typically takes about 2 to 4 hours, depending on the complexity and the patient’s specific anatomical considerations.

Setting

This surgery is performed in a hospital or specialized surgical center equipped with pediatric and plastic surgery facilities.

Personnel

The surgical team usually includes a plastic surgeon, pediatric anesthesiologist, surgical nurses, and possibly a pediatrician for intraoperative monitoring.

Risks and Complications

• Common risks include bleeding, infection, and scarring.
• Rare complications could involve anesthesia reactions, asymmetry, or the need for additional surgeries.
• Postoperative monitoring and good wound care are essential to minimize risks.

Benefits

• Improved facial appearance and symmetry.
• Enhanced functional outcomes, including feeding and speech.
• Psychological and social benefits from corrected facial aesthetics.
• Benefits are typically noticed soon after recovery, with long-term improvements in quality of life.

Recovery

• Post-procedure care involves keeping the surgical area clean and protected.
• Pain management typically includes prescribed pain relief medications.
• Recovery time ranges from a few weeks to a few months, with restrictions on certain activities.
• Follow-up appointments are necessary to monitor healing and development.

Alternatives

• Non-surgical options are limited but could include specialized feeding bottles or orthodontic devices.
• Staged surgical repairs could be an option but generally require multiple surgeries over time.
• Each alternative has its pros and cons, often weighed against the benefits of a one-stage repair.

Patient Experience

Patients, often infants, will be under general anesthesia during the procedure and will not experience pain during surgery. Postoperative discomfort is managed with medications. Parents and caregivers will receive guidance on comfort measures, wound care, and activity restrictions during the recovery period.