Mending the tiniest of faces

Manuel remembers the moment he realized that his baby girl born with a cleft lip and palate would be okay.

"As soon as we met her surgeon, we knew she was in the best hands possible," Manuel says.

James Seaward, M.D., plastic and craniofacial surgeon at Children's Health℠ and Assistant Professor of Pediatric Plastic and Craniofacial Surgery at UT Southwestern, met Manuel and his wife, Belinda, after an ultrasound revealed the cleft lip and palate. Their baby, Wendy, would need surgery to repair it.

"We were very nervous knowing our baby would be so small going into surgery," Manuel said.

Wendy was born with a complete right-sided cleft lip and submucous cleft palate. She had a complete gap in the upper lip all the way up to and including her nostril. The submucous cleft palate meant that Wendy's muscles that lift the palate were separated and the palate would not work as efficiently as it should.

When Wendy was 4 months old, Dr. Seaward reconstructed her nostril and muscle of the upper lip and the red and white parts of the lip skin to make her face as symmetrical as possible. The main risks with this surgery include problems with the scar and asymmetry in the face that result in a significant deformity. But the surgery was a success and Wendy recovered quickly.

"We were very happy to see her after surgery," Manuel says. "We felt so much joy because we could see the change in her little face and lips."

That dramatic change and its potential to impact a child's life for the better is what led Dr. Seaward to pursue pediatric plastic surgery.

"Repairing a cleft lip completely changes the psychosocial interactions that child will experience throughout their lifetime," Dr. Seaward says. "And repairing a cleft palate gives the child the ability to speak and be understood."

Dr. Seaward, who performs more than 100 cleft-related procedures each year, says that the big question with any cleft is how it will change over time.

"What we don't know immediately after surgery is if the scar will grow at the same rate as the rest of her face, or if she will need further surgery as she grows to keep her symmetrical," he explains. "We also will watch if her jaws grow at the same speed or if her lower jaw will outgrow her upper, or if her nose will change over time to the point that she needs further surgery."

As for now, the 3-year-old, who does not go anywhere without her beloved teddy bear, is thriving and eats everything her parents put in front of her, according to Manuel.

"Wendy is very affectionate and bright," Manuel says. "She likes to sing a lot. I can say with all the confidence in the world that Children's Health was the best place for her."

Manuel hopes Wendy continues to be the loving girl she is now, and that she does not let anything stand in her way.

"We will always be on her side 100 percent."

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The Fogelson Plastic Surgery and Craniofacial Center at Children's Health provides diagnosis and treatment for children of any age with any reconstructive need. Learn more about our programs and services.