What does orthognathic surgery for bilateral complete cleft lip and palate involve?

Bone grafting: Typically these procedures involve a lot of bone grafting, often enough that it has to be completed in multiple surgeries. Block grafts of bone are typically held in place by screws and plates to stabilize them during the healing phase.

Facial balance: Most people with bilateral cleft lip have decreased projection of the maxilla (midface) which gives a flattened appearance below the eyes, cheeks and upper lip. Orthognatic surgery corrects this.

Many surgeries : This surgery can include repair of the lip and nose by clipping then sewing the tissues together in the first 6 months of life. The palate (roof of mouth) repair around 12-18 months of age involves sewing the two sides together. A repair of a cleft in the gumline may involve adding bone and orthodontics (braces) usually 9-12 years old.

Clefts and Jaw Sx: In cleft patients, it is common for the maxilla to fail to develop along normal growth patterns, a lot of this has to do with scarring from previous surgeries. In order to correct for this underdevelopment of the upper jaw, orthognathic surgery is performed. Typically, the upper jaw is advanced forward, and because it is a bilateral cleft, it will technically be a three-piece segmental LeFort.