Most of the plastic surgeons in the world repair lip when the child is of 2-3 months of the age. Some centers in the world do this operation soon after birth. The argument put forward to is that because of the early repair, nobody in the society comes to know about the deformity. Also the parents do not have to undergo psychological trauma of seeing a child with the deformity. However, in our country, the child is seen within hours of birth by all his near and distant relatives. It thus becomes very difficult to keep the deformity secret. Small clefts may be repaired at this age in an otherwise healthy child. Wider clefts should better be repaired when the size of the tissue is more manageable.

Many a times when the cleft lip is associated with the cleft alveolus and the cleft palate, it becomes necessary to give the child, pre surgical orthodontics. The orthodontist at this age, intervenes to align the alveolus on the sides of the cleft. This leads to better alignment of the lip during surgery and better post operative result. If the child is operated upon immediately after birth, the important step of orthodontic management is missed. This leads to unnecessary stretch over the newly repaired, delicate lip tissue. In some cases, it may even lead to bursting open of the stitches too.

The operation is done under general anesthesia, that is, the child is put to complete unconsciousness. The feedings and water is stopped 4 hours before the surgery. During this time, if the child cries, the attending doctor or the nurse may give him drug to put him to sleep. But under no circumstances, parents should give any thing to pacify the child.

The repairing of lip is not as simple as it appears. Unlike what one may think, the plastic surgeon just does not cut the margins and take stitches. During operation, the plastic surgeon repairs the lips by cutting both the side after according to standard but complex design. Stitches are then taken carefully to give a natural looking lip. Feeds are started about 2 - 4 hours after surgery. If the child is breast feeding, the breast milk can be extracted and be given to the child through the spoon. A dressing is applied to the lip for about 5 days and changed as and when necessary. The stitches are removed on 5th day. To keep the child steady during the stitch removal, some drug is given or the child is given anesthesia for about 5-10 minutes.