Cleft Lip and Cleft Palate Surgery: Timing, Steps and Recovery
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is cleft lip and cleft palate surgery?
Cleft lip and cleft palate surgery is a series of operations that close a split in a baby's upper lip and the roof of the mouth. Lip repair usually happens at 3 to 6 months and palate repair around 12 months, under general anesthesia, to help with eating, breathing, hearing and speech. [1]
What the research says
Earlier palate repair was linked to fewer speech-airflow problems by age 5. In a trial of 558 infants with isolated cleft palate across 23 centers, 8.9% of babies operated on at 6 months had velopharyngeal insufficiency at age 5, compared with 15.0% of those operated on at 12 months. Complications were infrequent and similar in both groups. (Gamble et al., N Engl J Med, 2023)
The palate repair technique affects how often a second speech surgery is needed. Pooling 54 studies, speech-correcting surgery was needed after 19% of straight-line palate repairs, compared with 6% after Z-palatoplasty and 7% after repairs using buccal flaps. (Hofman et al., Clin Oral Investig, 2024)
Pre-surgery nasoalveolar molding narrows the cleft before the first operation. Across 21 studies (534 infants with one-sided cleft lip and palate, 368 treated with molding), the gum gap narrowed from about 10.7 mm to 3.9 mm after an average of 96 days, and nostril symmetry improved. (Bayan et al., Cleft Palate Craniofac J, 2026)
Key takeaways
Lip repair is usually done at 3–6 months; palate repair at around 12 months, before a child learns to talk.
If a child has both, the lip is repaired first.
Lip repair usually takes one surgery; palate repair can take two. Some gum and jaw procedures wait until age 10 or older.
Children sleep through surgery under general anesthesia and feel no pain during it.
Full recovery can take up to four weeks, a little longer after palate repair.
Call the doctor right away for fever above 101.4°F (38.55°C), breathing trouble, bleeding or signs of dehydration.
What are cleft lip and cleft palate?
A cleft lip and a cleft palate are splits in a baby's upper lip and the roof of the mouth that form before birth, when tissues don't join together properly during development in the uterus. [1]
Cleft lip: a narrow or wide opening between the two sides of the upper lip. It can include the gums and nostrils and extend to the palate.
Cleft palate: an opening in the roof of the mouth. It can involve the bony front part, the soft back part, or both.
They can happen alone or together. Having both a cleft lip and a cleft palate is the most common pattern. [1]
What does cleft lip and cleft palate surgery fix?
Cleft lip and cleft palate surgery restores how the lips and mouth work and corrects their appearance. [1]
Clefts are linked to hearing loss, dental problems and speech problems. Surgery helps a child:
Eat and drink
Breathe
Hear
Speak
Without repair, a child with a cleft is at risk for frequent ear infections or fluid behind the eardrum, trouble feeding or swallowing, hearing loss, fluid coming out of the nose, speech delays and dental problems. [1]
At what age is cleft lip and cleft palate surgery done?
Cleft lip surgery is typically done at 3 to 6 months of age, and cleft palate surgery at around 12 months, before the child learns to talk. [1]
Most cleft care follows this order, but your child's team sets the exact schedule.
Stage | Typical age | What happens |
Preparation | Shortly after birth | Lip taping, a nasal elevator or nasoalveolar molding (NAM) to position the tissues |
Lip repair | 3–6 months | Closes the lip gap and shapes the upper lip and nostrils |
Palate repair | Around 12 months | Closes the roof of the mouth |
Gum and jaw procedures | 10 years or older | Some palate-related treatments wait until this age |
Follow-up surgery | Childhood to teens | A second lip surgery or nose surgery may be needed |
If a child has both a cleft lip and a cleft palate, the lip is repaired first. [1]
How many surgeries does it take to fix a cleft lip and cleft palate?
The number of surgeries depends on how severe the cleft is and whether other health conditions are present. Cleft lip repair usually needs one surgery, while cleft palate repair can take two. [1]
Your child's healthcare provider can estimate how many operations your child will need.
What happens before cleft lip and cleft palate surgery?
Before cleft lip and cleft palate surgery, a team that includes surgeons, speech therapists, head and neck surgeons (otolaryngologists) and dentists evaluates the cleft and plans the best surgical treatment. [1]
The week before surgery, your child's pediatrician checks that your child is healthy enough for the operation, reviews medical history and allergies, and may ask you to pause certain medicines.
Your child needs an empty stomach for anesthesia. Typical feeding rules look like this:
Food or drink | When to stop before surgery |
Formula or cow's milk | At least 6 hours before |
Breast milk | Often allowed up to 4 hours before |
Clear liquids (water, apple juice) | Up to 3 hours before |
Solid food or baby food | From midnight on the day of surgery |
Always follow the exact instructions your child's surgeon gives you, since they depend on your child's age. [1]
What happens during cleft lip surgery?
During cleft lip surgery, the surgeon closes the gap in the lip and improves the shape of the upper lip and nose. [1]
Your baby is put to sleep with general anesthesia.
The surgeon makes cuts on each side of the cleft, extending up toward the nose, to create flaps of skin.
The lip muscle is brought back together and the skin edges are joined to shape the lip and nostrils.
Dissolving stitches close the wound.
The operation takes less than two hours. Your child stays in the hospital overnight so the team can check how well they handled surgery. [1]
What happens during cleft palate surgery?
During cleft palate surgery, the surgeon closes the opening in the roof of the mouth so the palate can support normal speech and stop food from coming out of the nose. [1]
Your child sleeps under general anesthesia for the entire procedure and feels no pain.
The surgeon makes cuts on each side of the palate.
Layers of tissue in the roof of the mouth and nasal cavity are loosened, stretched and rearranged.
The left and right sides are brought together and closed with dissolving stitches.
Palate surgery takes two to three hours, sometimes longer depending on the type of repair. [1]
How do cleft lip repair and cleft palate repair compare?
Cleft lip repair is shorter, happens earlier and usually needs one operation, while cleft palate repair is longer, happens around the first birthday and can need two operations. [1]
Cleft lip repair | Cleft palate repair | |
Typical age | 3–6 months | Around 12 months |
Time in surgery | Under 2 hours | 2–3 hours (can be longer) |
Hospital stay | Overnight | At least 1–2 days |
Stitches | Dissolve in 1–2 weeks | May last up to a month |
Pain and recovery | Most children back to usual self in about a week | Some pain for up to 2 weeks |
Usual number of surgeries | One | Can take two |
What should I expect right after cleft lip surgery?
Right after cleft lip surgery, your child may be fussier than usual and will wear soft splints or cuffs on the arms to stop them from touching the lip. [1]
Most children find the arm cuffs uncomfortable and irritating — this is expected.
Your child can start breast milk or formula soon after surgery, though feeding may be hard at first.
An IV gives fluids until your child can drink enough on their own.
What should I expect right after cleft palate surgery?
After cleft palate surgery, your child stays in the hospital for at least one or two days and drinks clear liquids from a cup only, with no utensils or straws. [1]
Swelling and small amounts of blood in the saliva are normal.
Stitches stay in the mouth for several weeks, though some dissolve sooner.
Your child may go home with prescription pain medicine and an antibiotic.
How do I care for my child at home after cleft lip surgery?
Home care after cleft lip surgery focuses on safe feeding, keeping the incision clean and dry, and managing pain for the first few days. [1]
Eating and drinking
Baby food is usually fine but must be watered down or given from a cup.
Straws are generally not safe after cleft lip surgery.
You may need a special bottle or syringe for formula or breast milk.
Ask your child's provider whether spoon-feeding is allowed.
Incision care
Expect swelling and bruising around the mouth for several days.
Keep the area clean (with warm water) and dry.
Stitches dissolve within one to two weeks.
A pink or red scar remains. It may feel hard at first and softens over time. Some providers suggest an ointment once stitches are out.
Scars sunburn easily, so apply sunscreen every time your child goes outside.
Pain
Your child may need pain medicine for the first few days. Follow the label instructions on infant pain relievers, and contact the provider if they don't seem to help.
Most children are back to their usual behavior about a week after surgery. [1]
How do I care for my child at home after cleft palate surgery?
Home care after cleft palate surgery means cup-only liquids, soft foods, gentle mouth care and pain control for up to two weeks. [1]
Eating and drinking
For several weeks, liquids from a cup only — no straws.
Soft or mashed foods only; nothing crunchy or hard.
Spoon-feeding is usually fine. Check the rules with your child's surgeon.
Incision care
Stitches may last up to a month.
Exposed bone on the sides of the palate is normal and fills in on its own.
A small amount of blood in saliva or mucus is expected.
The mouth stays swollen for at least a week.
Pain and breathing
Over-the-counter ibuprofen or acetaminophen can ease sore throat, neck and jaw pain, or earache.
Some pain for up to two weeks is expected and may affect eating, drinking and sleep.
Nasal drainage may increase and look pink or bloody.
Snoring and a stuffy, congested sound can last several weeks. [1]
How long does it take to recover from cleft lip and cleft palate surgery?
Recovery from cleft lip or cleft palate surgery can take up to four weeks, and palate repair may take a little longer because it is more complex. [1]
Your child's provider will schedule a check-up one to two weeks after surgery.
Is cleft lip and cleft palate surgery painful?
Cleft lip and cleft palate surgery is not painful during the operation because your child is asleep under general anesthesia. [1]
Your child will feel uncomfortable once the pain medicine wears off. Follow your surgeon's pain plan, comfort your child as much as you can, and ask what is normal during recovery.
What are the risks of cleft lip and cleft palate surgery?
Cleft lip and cleft palate surgery is generally very safe, but like most operations it carries some risks. [1]
The most common risks are:
Bleeding
Infection
Reactions to anesthesia
Breathing problems
Surgery that isn't fully successful, or the need for more surgeries
When should I call the doctor after cleft surgery?
After cleft lip or cleft palate surgery, call your child's provider right away for a high or stubborn fever, breathing trouble, bleeding, infection signs, dehydration or an opened incision. [1]
Call right away if your child has:
A fever higher than 101.4°F (38.55°C), or a fever that doesn't respond to medicine
Trouble breathing, or blue or pale skin
Bleeding from the nose or mouth (pink mucus and saliva are normal)
Pus or bleeding from the incision
Signs of dehydration: no tears when crying, sunken eyes, dry mouth, or fewer wet diapers (less than one every six hours)
Redness or severe swelling at the incision
An incision that opens or stitches that come loose
Conclusion
Cleft lip and cleft palate surgery happens in steps: preparation after birth, lip repair at 3–6 months, palate repair around 12 months, and sometimes later procedures for the gums, jaw, lip or nose. Both main operations are done under general anesthesia, and most children recover within about four weeks.
The most helpful things you can do are keep your child calm and comfortable, follow every post-op instruction closely, and ask your surgeon anything you're unsure about. Most children with a cleft lip and palate are treated successfully with no long-term problems. [1] Speech follow-up matters too — learn how palate function affects talking in our guide to velopharyngeal dysfunction.
Preparing for your child's surgery? Save or print this guide and bring it to your pre-surgery visit, then explore more plain-language, doctor-reviewed child health guides on Rinnit.com.
FAQ
At what age is cleft lip surgery done?
Cleft lip surgery is typically done when a baby is 3 to 6 months old. Some babies first have lip taping, a nasal elevator or nasoalveolar molding to prepare the tissues.
At what age is cleft palate surgery done?
Cleft palate surgery is usually done at around 12 months, before a child learns to talk. If a child also has a cleft lip, the lip is repaired first.
How long does cleft lip surgery take?
Cleft lip surgery takes less than two hours, and children usually stay in the hospital for one night.
How long does cleft palate surgery take?
Cleft palate surgery takes two to three hours and can take longer depending on the type of repair. Children stay in the hospital for at least one or two days.
Can my baby use a straw or bottle after cleft surgery?
Straws are generally not safe after cleft lip or cleft palate surgery. After lip repair, a special bottle or syringe may be needed; after palate repair, liquids are given from a cup only.
How long do stitches last after cleft surgery?
Lip stitches usually dissolve within one to two weeks. Palate stitches can last up to a month, although some dissolve sooner.
Will my child need more than one cleft surgery?
Many children do. Cleft lip repair usually needs one surgery, cleft palate repair can take two, and some gum, jaw or nose procedures happen later, sometimes after age 10.
Will my child have a scar after cleft lip surgery?
Yes, there will be a scar on the upper lip. Surgeons place it along natural lines, and it usually fades a lot over time.
Will my child need speech therapy after cleft palate surgery?
Many children do. A speech therapist checks your child's speech as they grow and helps with any problems early.
Will my baby need arm restraints after cleft surgery?
Some surgeons use soft arm restraints for a short time to keep the baby's hands away from the mouth. Follow your surgeon's instructions on whether and how long to use them.
Related reading on Rinnit.com
Related Reading
Plastic Surgery: Reconstructive and Cosmetic Types, Risks and Recovery explains reconstructive and cosmetic plastic surgery.
References
Cleveland Clinic. Cleft Lip & Cleft Palate Surgery: Repair Steps & Post-op Care. Cleveland Clinic. Last updated June 13, 2022. https://my.clevelandclinic.org/health/treatments/23394-cleft-lip-cleft-palate-surgery
Gamble C, Persson C, Willadsen E, et al. Timing of primary surgery for cleft palate. N Engl J Med. 2023;389(9):795-807. PMID 37646677. https://doi.org/10.1056/NEJMoa2215162
Hofman L, van Dongen JA, van Rees RCM, et al. Speech correcting surgery after primary palatoplasty: a systematic literature review and meta-analysis. Clin Oral Investig. 2024;28(1):58. PMID 38157017. https://doi.org/10.1007/s00784-023-05391-7
Bayan L, Nordahl E, Huynh K, et al. Grayson's technique for presurgical nasoalveolar molding (PNAM) in unilateral cleft lip and palate: a systematic review and single-arm meta-analysis. Cleft Palate Craniofac J. 2026;63(9):2886-2897. PMID 41263946. https://doi.org/10.1177/10556656251395936
Medical disclaimer
This article is for general education only and does not replace advice from your child's surgeon, pediatrician or cleft care team. Always follow the specific instructions you are given before and after surgery.
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