Cleft Lip and Palate 

The UCLA Craniofacial Clinic is one of the largest centers in the US and provides consultative and surgical treatment for patients on a weekly basis.
Our team is composed of internationally recognized experts who provide state-of-the-art treatment for all children with birth defects.
The UCLA Medical Center, which includes the Mattel-UCLA Children's Hospital, is rated as one of the top four hospitals in the United States and the best hospital in the western United States.
The UCLA Pediatric Plastic Surgery Team is internationally recognized for its commitment and quality and is one of the most longstanding track records in the world.
UCLA School of Dentistry, which works intimately with the Plastic Surgery Team, is ranked as one of the top five in the United States and is the only US dental school with clinics dedicated for children with complex facial birth defects.

One in 400 to 600 infants are born with a cleft lip and/or palate deformity (unilateral cleft lip, bilateral cleft lip or in combination with a cleft palate or cleft palate alone).
The UCLA Craniofacial Center has a team of specialists dedicated to the treatment of cleft patients from in infancy to maturity. During a visit to the Center, patients are evaluated by craniofacial surgeons, pediatricians, geneticists, orthodontists, pediatric dentists, speech pathologists, neurosurgeons, otolaryngologists, oral surgeons, otologists, psychiatrists, ophthalmologists and social workers. As a group the team of specialists will form a treatment plan. The patient, the family and referring health care provider will then be informed of management options.

Surgical time course (may vary):
1)Antenatal consultation (before birth) for parents who receive an in utero diagnosis of a clefting problem relieve anxiety and provide necessary information.
2)After birth, presurgical nasoalveolar molding (PNAM) device is fashioned by the prostodontal member of the team (Dr. Ting-Ling Chang). (Please see patient image on the right). This is effective in approximating the alveolar segments (brings the gum line together) and improves nasal shape.
3)At 3 months of age repair of the cleft lip and nose deformity is performed by the plastic surgeon.
4)At 10 to 14 months of age the cleft palate is repaired. Ear tubes (myringotomy tubes) may also be placed at this time by the otolaryngologist (ENT).
5)Prior to school age cleft lip scar revision or nasal revision may be performed to optimize appearance.
6)Speech is monitored closely in yearly visits. In approximately 15% of patients, a second palatal surgery (pharyngeoplasty or pharyngeal flap) are necessary.
7)After permanent molars eruption (age 6-8) orthodontic expansion is performed. A bone graft from the hip to the space in the alveolar ridge (gum line) is then placed.
8)In the teenage years patients require orthodontics and may require an upper jaw advancement (Le Fort I orthagnathic procedure) if jaw growth falls behind.
9)As a final stage, correction of nasal deviation with a septorhinoplasty is performed.
As each patient is unique, the above procedures are necessary only when agreed on by the UCLA Craniofacial team, the patient and family.