Lip Adhesion

Lip Adhesion is a surgical method that is used to bring the cleft closer together before repair. It is done on both unilateral and bilateral cleft lips. Lip adhesion basically involves sewing the edges of the cleft together between 6 weeks and 3 months of age, and then going back about 6 weeks to 3 months later to perform the actual repair. The purpose of the lip adhesion is to reduce the tension on the final repair, which potentially might make the scar narrower. Some surgeons might also require that you tape prior to the adhesion to help narrow the cleft even before adhesion. Remember, every surgeon is different, so the timelines will vary…so make sure you ask your surgeon about specific timelines.

The pros of a lip adhesion is that it’s minimal work on you, as the parent. So if you are a very busy mommy, with work or other children…this might be the route you want to go. You will not be required to attend the weekly visits that a lot of the other pre-surgical techniques require you to do.

The cons of a lip adhesion is that it does require an additional surgery, and based on the severity of the cleft (how wide) there is a small chance that the adhesion will not hold.

Meet Carson

Carson at birth

After taping – before Adhesion

After Lip Adhesion – Before Repair

After Repair

Hear about the adhesion process from Carson’s Mom

“Carson was born with a right complete unilateral cleft lip and palate. We started the adventures of taping when he was just 2-3 weeks old. The tape was specifically designed for a cleft mouth, one end was just a standard square end and the other end was a circle, for the cleft side. The tape was to keep the lip pulled together and also to push against the gum line that was protruding out way further than it should have been. And the crazy thing is – IT WORKED. The tape pushed his gum line down almost where it needed to be.

At 3 ½ months old, he had a lip adhesion surgery. The reason for doing this type of surgery, instead of just repairing the lip, is to continue to push the gum line down. It took the place of the tape! It’s also to make it like he was born with an incomplete cleft lip, instead of the wide complete cleft lip, which makes the lip/nose repair much better. His lip adhesion healed beautifully and did just as it was intended to do. When Carson was 6 ½ months he had the lip/nose repair. It went smoothly and he’s healing and recovering extremely well!

Pros of the tape – Our surgeon knew that it worked and had seen great results, otherwise he wouldn’t continue using it. We trust our surgeon completely! Taping was also something that I picked up on quickly, a skill I never dreamed I’d have. It didn’t hurt him to have it on, actually I am quite sure he just got use to it. Maybe even having his lip pulled together made drinking from the bottle a little easier.

Cons of the tape – The tape got a little gunky from eating with it on and spitting up on it. It also made his skin really red underneath. I gave him a few small breaks from it, to let his cheeks heal a bit. Regardless of the cons, I knew it worked and that it’s the course of action we were following… all because of what was best for my baby!

Pros of the lip adhesion – It seems like maybe it helped him eat better to have his lip more permanently pulled together, instead of just being held together by the tape. And we didn’t have to use the tape anymore, hooray!

Cons of the lip adhesion – My son was only 3 ½ months old and had to be put under and go through a surgery and recovery. I don’t know that it’s okay at any age, but 3 ½ months seems too young to have to go through something like this.” – Jamie Neally

Meet Jarrett

Jarret at birth

Before Lip Adhesion

After Lip Adhesion

After Repair

Hear about the adhesion process from Jarrett’s Mom

“We found out about Jarrett’s cleft when I was 18 weeks pregnant. Ultrasound showed that he would be born with a left unilateral cleft lip and possible cleft palate. We were referred to Nationwide Children’s Hospital to meet with the cleft team prior to Jarrett’s birth. I was born with a bilateral cleft lip and palate that was repaired at NCH, and although my surgeon has since retired, I had complete faith in that hospital. It never occurred to me to look for a different team and I honestly was unaware of different pre-surgical techniques. We met with Dr. Kirschner and he went over lip adhesion, lip repair and palate repair. We were told to call them when Jarrett was born and they would see him within a week to assess the severity of his cleft and discuss the plan for repair in more detail.

On May 28th, 2013 at 12:30pm we met Jarrett for the first time. His cleft was quite wide and he did in fact have a cleft palate as well. We stayed in the hospital for 2 days and met with our cleft team when he was only a few days old. Dr. Kirschner took some pictures of Jarrett and determined that we would not have to do any taping prior to the lip adhesion. I was glad that we would be able to skip this step and save us all some stress. He informed us that at 3 months of age, on September 4th, he would perform the lip adhesion and place a nasal stent in Jarrett’s nose. He said the stent would help create a more symmetrical look following the final repair.

On surgery day we went through pre-op procedures and then Jarrett was taken back for surgery. Ear tubes were also placed during this first procedure and altogether surgery lasted about an hour and a half. The doctor stitched Jarrett’s lip together near his nostril so the lip would be ready for the final repair, to take place at 6 months. A nasal stent was placed in his nostrils and stitched through his septum and would stay there until lip repair. The stent began to shape Jarrett’s left nostril. We were told to try to keep Jarrett as content as possible because hard crying or big smiles could pull the adhesion apart. The first week post-op was stressful, but after that his lip healed great and it was back to life as usual. The stent didn’t bother Jarrett at all. It was too small and his coordination wasn’t developed enough yet for him to get ahold of it. We put saline drops in his nose at night to keep his nostrils clear, but other than that, we didn’t have to do anything.

The final repair took place at 6 months and I couldn’t be happier with the results. Lip adhesion added a surgery to the repair process but recovery was quick, Jarrett was back to himself within a week, and it didn’t disrupt his feeding at all. We were permitted to use his regular pigeon nipple bottle immediately following surgery. I felt that this pre-surgery method was great for us and our hectic life. With two older sisters and his dad and I both having full-time jobs, we were able to get excellent results with little disruption to our daily lives.” – Jessica Wilson

Meet Blake

Blake at Birth

With Tape

After Adhesion

After Repair

Hear about the adhesion process from Blake’s Mom

“My son (Blake) is a twin & is now 8 months old. We found out about the cleft lip & possible palate at my 20 week ultrasound. Unfortunately, my pregnancy was very eventful & ended with the twins being born 9 weeks early at 31 weeks. Blake’s twin was home in 4 weeks but Blake spent just over 9 weeks in the NICU which delayed meeting the Cleft Team for the first time.We met with local & out of state surgeons & decided on Nationwide Children’s in Columbus ohio. It is a 3 hr commute & wonder if things would have moved faster if we were local to the Cleft team. Met with cleft team for first time when Blake was 2 1/2 months old.Started taping just before his 3 month bday. First lip adhesion at 5 months old and 2nd lip adhesion just after Blake turned 6 months. Blake just had lip repair at 8 months”- Katie Guntle