Cleft Lip & Palate

Cleft lip and palate are the most common congenital deformities of the face, affecting nearly 1000 children a year in California alone. There is a wide variation in presentation, from small deficiencies in the lip alone to complete clefts through the lip, gum, nose and palate. Treatment of these, as with other deformities involving the growth of the jaws, requires multiple specialties: orthodontics, speech pathology, oral and maxillofacial surgery, as well as plastic surgery. The plastic surgeon's role in the care of these patients involves the surgical repair of the cleft lip and palate in the first year of life as well as multiple procedures during growth of the face. Modern treatment methods can produce children with a normal or near normal appearance and normal speech in most cases.

Microtia, in which there is lack of development of the ear, involves loss of the external ear as well as markedly decreased hearing. Again, reconstruction involves a coordinated effort between the otolaryngologist and the plastic surgeon. Reconstruction of the external ear is performed with the patient's own rib carved into an ear, followed by two or three smaller operations to create a normal ear (except for the lack of flexibility), and the otolaryngologist can reconstruct the ear canal or place a bone-anchored hearing aid (BAHA) to improve hearing on the affected side. Our microtia clinic brings the involved specialties together to evaluate and treat the patient in a single setting.

The UCSF Craniofacial Center is one of the oldest in the country and has treated thousands of children with cleft lip and cleft palate, craniosynostosis, hemifacial microsomia, and other congenital disorders (including Apert, Crouzon, and Pfeiffer syndromes, among others).

This interdisciplinary group brings many areas of expertise to a single visit by a patient and their family. Our plastic surgeons have a long experience dealing with these problems with excellent outcomes. Other specialty clinics at UCSF Children's Hospital include the Microtia Clinic (for children who have failed to develop one or both ears) and the Birthmarks and Vascular Anomalies Clinic, for hemangiomas and other vascular malformations.