Cleft Lip, Cleft Palate & Craniofacial Surgery

Life-Changing Care Begins Here

Every year, thousands of families face the unexpected news that their child will be born with a cleft lip, cleft palate, or another craniofacial abnormality. For many, this diagnosis sparks a mix of fear, uncertainty, and countless questions: What does this mean for my child’s health? How will this affect their speech, feeding, or social life? What treatments are available, and will they truly make a difference?

At the Carolinas Center for Cleft & Craniofacial Surgery, part of the Carolinas Center for Oral & Facial Surgery, these questions are met with answers grounded in decades of experience, cutting-edge surgical care, and a deep commitment to every child’s well-being. Our multidisciplinary team provides not just medical expertise but unwavering support, guiding families through every step of their journey.

“We’re here to provide hope and answers,” Dr. Rick Kapitan, oral and maxillofacial surgeon and Director and Founder of Carolinas Center for Cleft & Craniofacial Surgery adds. “We meet each child and family exactly where they are, and we stay with them as long as they need us.”  

Understanding Cleft Lip and Cleft Palate

The foundation of facial structure forms very early during pregnancy, as different parts of the face come together and fuse. When this process is interrupted, a baby may be born with a cleft lip, cleft palate, or both.

A cleft lip is a visible gap or split in the upper lip, which can occur on one side (unilateral) or both sides (bilateral). This physical difference is apparent immediately after birth. In contrast, a cleft palate, an opening in the roof of the mouth, is often less visible but can have profound effects on feeding, speech, hearing, and dental development.

These conditions are among the most common congenital facial abnormalities, occurring in about 1 in 1000 children born in the United States. Yet, despite the numbers, every child’s experience is deeply personal and unique.

The Surgical Journey: Timing and Techniques

At our practice, we carefully tailor surgical interventions to each child’s stage of development, aiming to restore both function and appearance in ways that grow with them.

Cleft Lip Repair is usually performed between 3 and 6 months of age. This initial surgery focuses on reconstructing the lip to restore its shape and muscular function, enabling your child to express emotion naturally and feed effectively. While the primary repair sets the foundation, some children may require minor revisions as they grow, to fine-tune appearance and symmetry.

Cleft Palate Repair is generally scheduled between 12 and 16 months of age. Closing the palate at this critical stage supports better feeding, reduces ear infections, and is essential for developing clear speech. Often, ear tubes are placed simultaneously to prevent fluid buildup and infections that can affect hearing. Around this time, children typically begin speech therapy, which is an important part of achieving their full communication potential.

As children grow, further procedures may become necessary. Alveolar bone grafting, often performed between ages 7 and 9, strengthens the upper jaw to support adult teeth and stabilize the nasal base. Nasal revisions and jaw surgeries might also be recommended during late adolescence, between ages 17 and 18, to enhance function and facial harmony.

Throughout these stages, our team remains a constant, offering personalized, long-term care plans that evolve alongside your child’s needs.

“Carolinas Center for Oral & Facial Surgery has been providing cleft care for over 12 years, the entire time I’ve been with the practice,” shares Dr. Mohamed, oral and maxillofacial surgeon.

Addressing Advanced Craniofacial Challenges

While cleft lip and palate are the most well-known craniofacial conditions, some children face even more complex challenges that require specialized care and advanced surgical techniques.

Craniosynostosis is a condition where one or more of the sutures in a baby’s skull close prematurely, causing abnormal head shapes and, in some cases, increasing pressure inside the skull. Early diagnosis and surgical intervention are critical within the first year of life to allow the brain to grow properly and the skull to develop a normal shape.

Hemifacial Microsomia affects one side of the face, resulting in underdevelopment of structures such as the jaw, ear, cheekbone, and facial nerves. Children with this condition may experience difficulties with chewing, hearing, breathing, and facial symmetry. Treatment often involves a combination of surgeries over time, including distraction osteogenesis (a technique to gradually lengthen bones), ear reconstruction, and corrective jaw surgery during adolescence.

Additionally, some children are born with extensive facial clefts that extend beyond the lip and palate, affecting areas such as the eye, cheek, or forehead. These cases demand meticulous, staged reconstruction and close collaboration between multiple surgical specialties to achieve the best possible functional and aesthetic outcomes.

“There are so many treatment options available today,” explains Dr. Mohamed. “With modern technology and the right care team, we can help your child live the most normal life possible.”

ACPA-Accredited Cleft & Craniofacial Center

Not all cleft and craniofacial care centers are created equal. The American Cleft Palate-Craniofacial Association (ACPA) accreditation is the gold standard, indicating a program meets rigorous criteria in multidisciplinary care, patient outcomes, and family support.

Carolinas Center for Oral & Facial Surgery is proud to be one of only five ACPA-accredited cleft and craniofacial centers in the United States that operates outside a hospital or university setting. This unique positioning allows us to offer personalized attention in a warm, family-centered environment while maintaining the highest standards of surgical excellence.

Our patients benefit from:

• Board-certified, fellowship-trained surgeons with deep expertise in cleft and craniofacial surgery
• Seamless collaboration with a team of specialists including ENT physicians, speech-language pathologists, audiologists, orthodontists, and pediatric dentists
• A supportive atmosphere that empowers families with education, resources, and compassionate care
• Lifelong follow-up to monitor growth and address evolving needs

“This holistic approach is designed not just to treat a condition, but to support a child’s full life, socially, emotionally, and physically”, says Dr. Kapitan.

Putting Families at the Center of Care

Technical skill and medical knowledge are essential. But what truly makes a difference is the compassion that underpins every interaction, every surgery, and every care plan.

Families often describe their relief and gratitude when they see the results, not only the physical transformation but the confidence their child gains. For many parents, the journey is as emotional as it is medical.

“Seeing the parents and the smiles on their faces, seeing the results, and witnessing the immediate satisfaction and gratitude they feel after these procedures, not just for their child, but for themselves as parents, that makes it all worthwhile,” says Dr. Cook, oral and maxillofacial surgeon.

Take the Next Step Toward Expert Care

No family should navigate this journey alone. Whether your child is facing a cleft lip, cleft palate, or a complex craniofacial condition, the Carolinas Center for Cleft & Craniofacial Surgery is here to provide expert care grounded in compassion and experience.

We encourage you to connect with our team; ask questions, share your concerns, and schedule a personalized consultation. Together, we will develop a tailored treatment plan designed to meet your child’s unique needs.