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  4. Cleft-Craniofacial Services

Cleft-Craniofacial Team

The Cleft-Craniofacial Teams at Baylor Scott & White McLane Children’s are available to evaluate, diagnose and treat individuals with cleft lip and palate or other craniofacial anomalies. Standards of care for patients with cleft lip and palate are established by the American Cleft Palate-Craniofacial Association. These standards require that coordinated care be provided by specialists in the fields of plastic surgery, orthodontics, speech language pathology, audiology, otolaryngology, pediatrics, general dentistry and oral surgery.

Treatment of cleft lip and/or palate is complex and is most effectively managed by collaboration of all of the team members. Although your child will not see each of these individuals at every visit or evaluation, their expertise is vital to the overall treatment plan. The team approach allows patients to benefit from coordinated, specialized care in all aspects of their treatment program.

Patients are seen at the Baylor Scott & White McLane Children’s Specialty Clinic in Temple.

Questions to Ask Your Doctor

Here are some frequently asked questions to help get you started asking your doctor about your child's care. Please feel free to ask your team doctors anything that you might be curious about. Remember, you are a major part of the team and no decisions will be made without you.

Questions for before surgery:

  • How long have you been doing these types of repairs?
  • How often do you research new cleft surgery procedures and review your own procedures?
  • Exactly how will the procedure be done? (Millard type surgery, Z-Plasty, strait line etc.)
  • How long will the surgery last?
  • What will the scars look like? Can I see pictures of children with similar scars whom you have worked on?
  • What types of physical distress will there be (i.e. swelling, bruising, redness of the area?) How long will these last?
  • Can I see pictures of children who have been through similar surgeries so I know what to expect? (hospital pics so as not to be surprised)
  • How long will the IV need to be in?
  • How long will she be in the hospital?
  • What type of sutures do you use (dissolving or none)?
  • When will the sutures be removed?
  • What type of diet/food restrictions will be required? Before and after surgery?
  • How soon after surgery can I hold my baby?
  • What are the discharge requirements? Will baby need to be eating/drinking so much liquid, have a certain number of wet diapers etc. before being released?

Questions regarding post-surgery

  • What types of events after surgery can make scarring worse?
  • What type of pain medicine can my child have? How often can he/she have it? Will he/she sleep a lot more due to drugs? Will we have a prescription for it or can we get it at the hospital?
  • Should we clean the sutures? How do we do this? How often? Do we need to put on a dressing (tape, gauze, Neosporin etc.?)
  • Whom should we call if we have any questions at all after surgery? Surgeon? Primary Care Physician?
  • What restrictions or limitations will she have after surgery? Will my child need to use arm restraints? For how long? What about supervised periods of time without them?
  • When will our follow-up visit be? Do I need to make this appointment myself or will the hospital staff make it for me?
  • What happens if he/she bumps his/her lip?

Questions about hospital policies:

  • Can we be present when the anesthesia is administered?
  • Are we allowed in the recovery room? When she wakes up, can we be there?
  • What will be the time spent in the recovery room?
  • What can we expect when we go to the hospital for surgery? Check-in procedures etc.
  • Are there any tests that need to be done the day of surgery, can we have them done ahead of time?
  • Can we stay with our child in the room?
  • Can we get copies of the paperwork that will need to be signed the day of surgery so that I may review it ahead of time?
  • What are parents responsible to bring? (For example, does the hospital or PS supply arm restraints or do the parents get those from an earlier visit and bring them?)

Questions for after surgery

  • Is it perfectly healed?
  • Can he/she resume normal activity like sleeping on her stomach and chewing on his/ her fingers?
  • Do we need to be concerned about him/her bumping it more then anything else?
  • For how long should we be extra cautious about sunlight and scarring?
  • Should we use Vitamin E oil or any products like scarEase? How often? How long?
  • How often does he/she need to come back for checkups?