Treatment Considerations

Timeline

  1. Impression at the OR when 7 to 14 days of age
  2. Fit appliance within a couple of days
  3. Addition of the nasal stent
  4. Adjust appliance weekly
  5. Remove wire components just prior to surgery
  6. Lip repair surgery at approximately 3 to 4 months of age
  7. Acrylic plate to stay in after lip surgery
  8. Palate surgery at 10 to 14 months after which acrylic plate is not needed

What's Next

Your baby's lip will be repaired by a plastic surgeon; with some exceptions, the surgery usually takes place at approximately 3 to 4 months of age. The day before your baby’s surgery, clean the plate and mouth of any denture adhesive, and reinsert the plate free of the adhesive. Dr. Loo also removes the nasal stent the day before the lip surgery, leaving the original plate.

When the lip has been repaired, taping usually stops permanently and the plate may be removed temporarily while the lip heals. If the plate is not in your baby’s mouth after the surgery, keep the plate in a safe place and leave it out until your plastic surgeon recommends you start 24-hour-a-day wear again. If the plate is in your baby’s mouth after the surgery, leave it in place for 7 to 10 days before you remove it to clean. Then return to 24-hour-a-day wear with more frequent cleanings.

This second phase of presurgical orthopedics is directed at encouraging the roof of the mouth to close naturally as much as possible prior to the palate repair surgery at 9 to 12 months. During this second phase of presurgical orthopedics, the plate should again be worn 24 hours per day and should be checked every 2 months or as recommended by Dr. Loo.

If you find the plate is not staying in place after the lip surgery, even with denture adhesive, call Dr. Loo and make an appointment to have the plate adjusted or possibly remade.