Cleft lip surgery is a major milestone in your baby’s journey, both medically and emotionally. For parents, it’s often a moment of relief and excitement—a step toward your child’s healing and future well-being. It’s also a major event you have always known was coming and have undoubtedly been building up to with anticipation. But it’s also important to understand that your baby’s face will change, and adjusting to these changes can bring a mix of emotions. Sometimes these emotions can take you by surprise, so preparing yourself for the physical and emotional transformations can make the experience smoother for you and your baby.
In this blog post, I’ll explore what to expect as your baby’s appearance changes after cleft lip surgery, how to manage your feelings, and how to support your child through this new phase.
Understanding the Physical Changes
Cleft lip surgery is designed to reconstruct the gap or separation in your baby’s upper lip, and is essential to improve both appearance and function. Here are the key physical changes you can expect:
Immediate Post-Surgery Appearance
When you see your baby in the recovery room straight after the surgery, their lip will likely appear swollen, red, and perhaps not as you imagined. Bloodied stitches and bruising may be visible and the lip may seem slightly uneven or ‘pulled’, which is normal as the tissue is healing. Many parents find this post-surgical appearance of their child’s face surprising, a bit unsettling, and sometimes even shocking, but it’s important to reassure yourself that it’s a temporary phase.
My advice is to try and do something calm, relaxing and even restorative while your child is in the operating room. Cleft repair surgeries are often quite long (at least a couple of hours if not longer), so take the opportunity to leave the hospital and go for a walk, get some food, and generally administer some self-care before you go back to collect your baby from the recovery room. You will need mental and physical strength to help your baby through the recovery process after their surgery, so try to make the most of this time.
Stitches, swelling and Bruising
Post-surgical swelling can make your baby’s face look different for several weeks. Bruising around the lip and nose area may occur, and some babies develop scabs around the incision that can look quite alarming. These are all natural parts of the healing process and will diminish over time. The stitches used for modern-day cleft surgery are often dissolvable which means that your baby won’t have to endure the sometimes uncomfortable experience of having them removed.
Long-Term Changes
As your baby heals over the weeks after cleft lip repair, their facial features will slowly start to settle into a more permanent form. The repaired lip will blend more naturally with the rest of the face as the swelling subsides. In some cases, future surgical procedures might be needed to further refine the lip or nose, but your child will already look different from the baby you were used to seeing after that first surgery. Cleft surgeons will usually discuss the possibility of the need for further surgeries with parents at a very early stage in the child’s cleft journey.
Emotional Adjustments for Parents
For many parents, the emotional journey following cleft lip surgery can be complex. You may feel relief when your child’s surgery comes around, and joy at seeing the repaired lip but also grief for the way your baby used to look. These mixed feelings are completely normal but you should try and prepare yourself for some unexpected or difficult emotions.
I arranged for some professional photographs to be taken the day before our son went into hospital to have his cleft lip and palate repaired. Unfortunately, the photographer was unwell that day, but a family friend came over to take some photographs instead. We have beautiful photos from that day; some of me, my husband and our son together, and some of just my son and I having kisses and cuddles together. These photos are so treasured given that this was the last day we would ever see him with his beautiful, wide cleft smile. Turning the day before the surgery into an event and a celebration of our son and how far he’d come definitely helped me cope with the dramatic change to his appearance.
Celebrating the Milestone
While it’s always difficult for parents to have their child undergo surgery of any kind, it’s important to recognise your child’s cleft surgery as a positive step for your baby’s health and future. The functional improvements — improved feeding and speech development — are critical milestones that are essential to your baby’s future well-being.
Allowing Yourself to Grieve
At the same time, it’s okay to acknowledge feelings of loss. The face you’ve come to know and love since birth is changing, and that can be emotional. Remember, it doesn’t mean you love your baby any less for having had a cleft lip or that the new appearance is any less beautiful. Give yourself permission to experience these feelings and know that it’s a natural part of the process.
Having been through the experience of seeing the appearance of my own baby’s face transformed by cleft lip surgery, the main thing I noticed was how much thinner his face suddenly seemed afterwards! It certainly took some getting used to, but having so many photos and videos of the 8 months with his cleft smile before the surgery to look back on massively helped.
Accepting the New Normal
As your baby’s face heals and settles into its new look, you’ll gradually get more used to their post-surgery appearance. Over time, this new version of your baby will feel just as familiar and beloved as the one before surgery and you will start to feel so grateful for the expert medical team who carried out the repair.
Helping Your Baby Through Recovery
Caring for your baby after cleft lip surgery won’t be easy and they will require extra attention and love as they heal. If you do find it tough going, keep reminding yourself that it’s only temporary, and that soon your baby will be fully recovered and back to their normal happy self.
Managing Post-Surgery Care
You’ll likely be given instructions for caring for your baby’s incision site, which may include cleaning it gently and monitoring for infection. Your doctor might also recommend keeping your baby’s hands away from their face to avoid touching the stitches, which can be a challenge but is important for proper healing. The use of arm restraints can sometimes help with this, although they are not always recommended.
Soothing and Comforting Your Baby
The healing process may cause discomfort for your baby. Swelling and tightness around the lip can make them irritable or uncomfortable. Offer soothing techniques such as gentle rocking, feeding, and singing to help calm them during this time. Pain management, as recommended by your cleft medical team, will also play a key role. The correct administration of the pain medication they send you home with is an essential part of ensuring your baby is as comfortable as possible during their recovery.
Feeding Adjustments
Most babies born with cleft lip adjust quickly and will often be feeding well before their surgery, either on milk or solids or both, and some may even be breastfeeding. Post-surgery recovery may require some further adjustments. Your surgeon or a lactation consultant might provide special instructions for feeding techniques or devices to help during the healing process. Sometimes it may be a case of trial and error during their recovery, and don’t be afraid to go back to using the squeezy bottles you used when they were born to feed them formula or breast milk if they are having difficulties. It’s best to avoid crunchy foods and stick to purees and other soft foods as well as milk in the beginning. If your baby has ongoing feeding issues post-surgery, and you don’t feel they’re getting enough fluids in particular, don’t hesitate to contact your child’s doctor or a cleft feeding specialist at the children’s hospital for support.
Looking Forward: Celebrating the Future
While the journey through cleft lip surgery is highly significant, it’s also just one chapter in your baby’s life. Once healed, they’ll be back to their normal happy self, and able to engage in activities and experiences that may have been challenging before, such as feeding more easily or beginning speech development with greater ease.
Building Confidence in Your Baby
As your baby grows, they may notice differences in their appearance or have questions about their surgery. Encourage a positive self-image from a young age by celebrating their uniqueness and strength. Remind them—and yourself—that their cleft lip is just one part of their story, but embrace and celebrate their cleft with them. Show them pictures of their cleft lip before the repair, and tell them how beautiful they looked. Tell them how much you miss it but how much you also love their new appearance.
I was born with a unilateral cleft lip myself, on the same side of the face as my son, so we have matching scars! I will always remember my mum telling me as I got older how sweet she thought I looked with my cleft and how much she missed it once they’d ‘stitched me up’. I make a point of telling my son how much I loved him with his cleft too, and how unique and special his scar makes him.
Continued Medical Follow-Ups
While the initial surgery is a significant step, some children may require additional surgeries or orthodontic work as they grow. Regular follow-ups with your medical team will ensure that your baby is progressing well and will help you stay informed about any future procedures.
Final Thoughts: Embracing the Journey
Cleft lip surgery is a hugely significant milestone in your child’s life. While the surgery is of course essential for your baby to have a bright and happy future and avoid cleft-related health issues, the changes to their face can trigger strong emotions for parents. The most important thing is to remember that your baby’s beauty isn’t defined by a single feature but by the love, care, and resilience that you’ve shared through this journey. Your cleft team will be a huge support to you during this time, and don’t be afraid to talk about your emotions with them during follow-up appointments after the surgery. Cleft departments are highly specialist and are made up of a multidisciplinary team of professionals who are there to help with every aspect of your child’s care and your family’s cleft journey. Don’t hesitate to ask them for help with your emotional well-being if you are struggling.
The best way to navigate your child’s cleft journey is to embrace each phase with an open heart, including when it comes to the significant change in their appearance following surgery. Allow yourself to feel proud of your child and yourself for the strength it takes to navigate such a transformative experience.
Further Links and Resources
Young children can find their cleft scar and different appearance easier to deal with than older children. For advice on helping your child cope with their cleft scar as they get older, particularly as they approach their teenage years when appearance can become so important to them, the following websites may be helpful:
https://www.cuh.nhs.uk/patient-information/talking-to-your-child-about-their-cleft/
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