Cleft Lip &
Palate Treatment
in Dallas–Fort Worth
A cleft lip or palate is one of the most common birth differences — and one of the most treatable. DFWOMS’s board-certified oral and maxillofacial surgeons provide compassionate, expert surgical care for children and families at our Irving, Mesquite, and Ennis locations.
A birth difference that is highly treatable
During early pregnancy, the different areas of the face develop individually and then fuse together. In babies who develop a cleft lip or palate, this fusion fails — leaving a gap (the cleft) in the affected area. Cleft defects occur in approximately 1 in every 800 births, making them one of the most common birth differences worldwide.
A cleft may involve the lip, the palate, or both — and can occur on one side (unilateral) or both sides (bilateral) of the face. While the appearance and impact of a cleft vary by severity, the good news is that with the skilled surgical care available at DFWOMS, results can be remarkably positive — giving children the best possible foundation for healthy development, speech, and confidence.
What is a cleft lip?
A cleft lip is an opening in the upper lip between the mouth and nose, caused by the failure of the lip structures to fuse during early fetal development. It can range from a slight notch in the colored portion of the lip to a complete separation that extends up through one or both sides of the lip and into the nose.
What is a cleft palate?
The palate is the roof of the mouth — a structure made of bone and muscle covered by mucosa that separates the mouth from the nasal cavity. It plays a critical role in both speech (preventing air from escaping through the nose) and eating (preventing food and liquid from entering the nose). A cleft palate occurs when the tissues that form the roof of the mouth fail to fuse during early pregnancy, leaving an opening.
A cleft palate can range from a small opening at the back of the soft palate to a nearly complete separation of both the soft and hard palate. The soft palate is the flexible rear portion of the roof of the mouth; the hard palate is the bony front portion. Because the lip and palate develop separately during fetal development, a child can be born with a cleft lip, a cleft palate, or both — each presenting different surgical needs and timing considerations.
Surgical treatment — cleft lip
Cleft lip repair is typically performed when the child is between 10 and 60 days old. Early repair restores normal appearance and muscle function at the critical stage when the child is developing feeding patterns and beginning to form sounds.
The goal of cleft lip surgery is to close the separation in the lip, restore the normal continuity and function of the orbicularis oris muscle (the muscle that controls lip movement), and create a natural shape to the lip and mouth. Incisions are planned to minimize visible scarring and to reconstruct the lip as symmetrically as possible.
Cleft lip is typically associated with a deformity of the nostril on the affected side. The nostril may be improved as a direct result of the lip repair, or it may require a separate subsequent surgery to fully restore nasal symmetry and proportion. Our surgeons evaluate each case individually and plan accordingly.
Following cleft lip repair, the child is monitored carefully during the healing period. Parents receive detailed instructions for wound care, feeding adaptations, and activity restrictions. Follow-up visits are scheduled to assess healing and plan any future stages of treatment that may be needed as the child grows.
Surgical treatment — cleft palate
Cleft palate treatment is staged according to the child’s age, the type and extent of the cleft, and any associated health considerations. Our surgeons work closely with the family and the child’s care team at every stage.
Initial cleft palate repair is performed when the child is between 7 and 18 months old, depending on the individual child’s situation and overall health. The major surgical goals are to close the gap between the roof of the mouth and the nose, reconnect the muscles that allow the palate to function correctly, and ensure the repaired palate is long enough to perform its role in speech and swallowing. If the child has other associated health conditions, surgery may be appropriately delayed.
The cleft hard palate is generally repaired between the ages of 8 and 12, timed to coincide with the development of the cuspid (canine) teeth. This procedure involves placing bone harvested from the hip into the bony defect, and closing the communication between the nose and gum tissue in three layers. The goal is to provide the bony support needed for proper tooth eruption, nasal floor integrity, and long-term facial stability.
Hard palate repair may also be performed in teenagers and adults — either as an individual procedure or combined with corrective orthognathic jaw surgery to address the skeletal effects that cleft palate can have on jaw growth and development. Some patients with clefts require jaw surgery in their teens or early adulthood to fully correct the functional and aesthetic impact of the condition.
What to expect after cleft palate repair
Surgery is only one part of a child’s cleft care journey. After the palate has been repaired, children will immediately have an easier time swallowing food and liquids — but ongoing support is essential for the best long-term outcomes.
Comprehensive, multidisciplinary cleft care
Children born with cleft lip and/or palate typically benefit from the coordinated care of a multidisciplinary team. No single specialist addresses every aspect of this condition — successful outcomes require collaboration across multiple disciplines.
A comprehensive cleft care team may include an oral and maxillofacial surgeon for the primary lip and palate repairs and bone grafting, a plastic surgeon for specific soft tissue refinements, an orthodontist to guide tooth development and jaw growth, a speech therapist to support language development, an audiologist to monitor hearing, a psychologist for emotional and developmental support, and a pediatrician for overall health oversight. At DFWOMS, our surgeons coordinate with each of these specialists to ensure your child receives seamlessly integrated, patient-centered care at every stage of development.
Expert cleft care for your child — and your family
Common questions about cleft lip & palate treatment
Cleft lip and palate result from the failure of facial structures to fully fuse during the first trimester of pregnancy. The cause is often multifactorial — involving a combination of genetic predisposition and environmental factors. Known risk factors include certain medications taken during pregnancy, nutritional deficiencies (particularly folic acid), smoking and alcohol use during pregnancy, and a family history of clefting. In many cases, no single cause can be identified. A cleft is not caused by anything a parent did wrong during pregnancy.
Cleft lip repair is typically performed between 10 and 60 days of age. This timing takes advantage of the child’s growth and tissue properties while the child is healthy and strong enough for the procedure. Early repair supports normal lip function for feeding and the development of early speech sounds, and allows the tissues to heal and remodel during a critical window of facial growth. Your surgeon will confirm the ideal timing based on your child’s individual health and development.
In most cases, yes — cleft care involves multiple staged procedures over the child’s development. A child with both a cleft lip and palate will typically have at minimum a lip repair in early infancy, a soft palate repair in the first year or two of life, and a hard palate bone graft between ages 8 and 12. Additional procedures for nostril refinement, jaw surgery, or secondary palate revision may be needed depending on how the child grows and responds to each stage of treatment. Our surgeons plan each stage carefully and keep the family fully informed.
Some scarring at the lip repair site is inevitable, but in the hands of an experienced surgeon it is typically minimal and fades significantly as the child grows. Incisions are placed carefully to follow natural skin lines and blend with the normal features of the lip. Most children achieve results that are natural-looking and aesthetically excellent. As the child gets older, secondary refinements to the lip or nose can be made if needed to optimize the final appearance.
A palatal fistula is a small opening that sometimes develops at the site of a palate repair, creating a new connection between the mouth and the nasal cavity. This occurs in approximately 1 in 5 children after palate repair. Small fistulas may cause only minor symptoms — such as occasional fluid entering the nose — and may be monitored without immediate intervention. Larger fistulas can significantly affect eating and speech, and typically require surgical repair. Our team monitors for fistula formation at every follow-up visit and addresses it promptly when needed.
Yes — cleft lip and palate treatment is generally covered by medical insurance as a medically necessary condition. We accept most major medical and dental insurance providers and Medicaid at all three of our DFW locations. Our team will assist you in understanding your coverage and navigating the insurance process, so that the focus can remain where it belongs — on your child’s care and recovery. Contact us before your consultation and we will help you work through the details.
Give your child the start they deserve.
Our oral surgeons in Irving, Mesquite, and Ennis are experienced, compassionate, and ready to partner with your family throughout every stage of cleft lip and palate treatment. Contact DFWOMS today to schedule a consultation.