Cleft Lip & Palate Repair
Cleft lip and palate repair aims to restore both function and form, helping patients achieve a natural appearance, clear speech, and confident expression
Procedure Overview
Cleft lip and palate repair is a reconstructive procedure that corrects separation of the lip, gum, or roof of the mouth present from birth. These conditions can affect feeding, speech, hearing, dental development, and appearance. Primary surgical repair aims to close the gap, restore function, and create a natural contour that blends seamlessly with surrounding features.
Surgery is often performed in stages depending on the child’s age and development, and may involve collaboration between plastic surgeons, ENT specialists, speech therapists, and orthodontists. While functional outcomes are essential, aesthetic results are also prioritised, with the goal of achieving symmetry and a natural appearance that supports long-term confidence.
In New Zealand, most primary cleft surgery is performed within the public hospital system during infancy, typically between three months and two years of age. Secondary procedures are carried out in stages thereafter, some of which may be performed in the private sector by specialist plastic surgeons such as Dr. de Chalain.
As he is no longer working in the public sector, Dr. de Chalain undertakes primary cleft surgery only on surgical missions to developing countries through the charity service Operation Restore Hope NZ. This team has been operating for 23 years and has conducted annual missions to the Philippines, Vietnam and Bangladesh, treating over 1,000 children to date.
In the New Zealand private sector, Dr. de Chalain continues to perform secondary cleft lip and nasal surgeries.
What to expect
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The consultation involves a careful assessment of your child’s cleft and an explanation of the recommended treatment plan. Dr. de Chalain will discuss the likely sequence of procedures, timing, and expected outcomes. Parents are encouraged to ask questions and may need more than one meeting to feel fully prepared.
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In most cases, cleft lip repair is performed between three and six months of age, while palate repair typically follows later in infancy or early childhood. Prior to surgery, your child may require specific feeding support or medical checks to ensure they are fit for anaesthesia. Clear pre-operative instructions will be provided.
Secondary procedures, such as lip scar revision or rhinoplasty, can be performed later, usually after the teenage years once skeletal maturity has been reached.
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The procedure is performed under general anaesthetic. Dr. de Chalain carefully repositions and joins the tissues of the lip or palate to create a continuous, functional structure. Special attention is given to achieving a natural appearance of the lip and nose, and to restoring the palate’s role in speech and swallowing.
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After surgery, your child will be closely monitored in hospital — sometimes overnight, sometimes longer, depending on their age and the type of repair. Dissolving stitches or protective dressings may be used. Feeding techniques may need to be adjusted temporarily, and our expert team will guide you through this.
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Healing takes place over a few weeks, with swelling and bruising gradually subsiding. For palate repair, some dietary modifications, such as soft foods, may be required during the healing phase. Most children bounce back quickly, though full recovery and functional improvements continue over time.
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Follow-up appointments are essential to monitor healing and assess speech and dental development. Dr. de Chalain may recommend additional treatments or future procedures as your child grows. Support from the wider cleft team, such as speech therapy or orthodontics, may also be part of the long-term plan.
Frequently Asked Questions
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For infants, cleft lip repair typically takes place around 3–6 months of age, and palate repair between 9–18 months, depending on the child’s needs. If additional procedures are required as a child grows, for example to refine the lip or nasal shape, these are planned on a case-by-case basis.
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Many people who had cleft repairs as children may seek refinement of scars, lip contour, or nasal symmetry as teenagers or adults. Revision surgery can help improve appearance and in some cases can improve function, such as nasal breathing or speech clarity.
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Depending on the individual, surgery can:
Restore or refine lip shape and contour
Improve nasal symmetry and tip position
Minimise or soften scar visibility
Support more natural facial balance
Address any functional issues related to the original cleft
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Recovery times vary depending on the patient’s age and the complexity of surgery. Infants and young children typically stay in hospital for a short period after surgery. Adults having revision surgery can often return to light activity within 1–2 weeks, with swelling and bruising gradually resolving over the following weeks. Dr. de Chalain and our expert team will provide clear aftercare instructions for a smooth healing process.
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Scarring is placed and refined carefully to blend with natural facial contours. In infants, scars tend to heal and fade remarkably well over time. In revision surgery, one of the main goals is to soften or minimise existing scars for a more natural appearance.
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No. While many procedures focus on improving facial appearance, cleft repair also plays an important role in restoring normal function, including speech, feeding, and breathing. Revision surgery may also provide functional benefits, particularly for nasal airflow.
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Results from cleft repair are typically long-lasting, especially when performed in early childhood. Refinements made later in life are designed to provide durable, natural results that harmonise with your facial features.
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Cleft surgery involves intricate reconstruction of the lip, nose, and palate, which are central to both facial appearance and function. A specialist plastic surgeon brings expertise in both reconstructive and aesthetic techniques, helping to achieve a result that supports confidence, comfort, and natural facial balance. Further, Dr. de Chalain has extensive experience and expertise in cleft repair, and since 1999 has run Operation Restore Hope NZ, a non-profit that provides cleft repair surgery to underserved communities in Vietnam, Bangladesh and the Philippines.
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The cost depends on whether the procedure is a primary repair or a revision, and on its complexity. Some primary surgeries may be publicly funded through Te Whatu Ora, while others are performed privately. A personalised cost estimate is provided after consultation. For more information on how our procedures are priced, please visit our Pricing Information page.
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