Smile Train
Best Smile Train - Cleft lip treatment in India
- In pursuit of happy faces since 2015
- More 3000 happy patients
Smile train is an international organization that is active in more than 90 countries and has helped in funding 15,00,000 surgeries across the globe since 1999. This organization provides free treatment to children born with a congenital deformity of the face called cleft lip and palate.
What is a Cleft lip?
Clefts are birth abnormalities that occur due to malformation of the lip & palate during pregnancy. It is a very common birth defect that occurs globally in 1 in every 700 neonates that are born. There is a predisposition of Cleft Lip in males with or without Cleft Palate & a predisposition for females in the case of Isolated Cleft Palate. Cleft lip & palate are mostly openings or splits in the lip & palate region due to incomplete closure during pregnancy. It can occur both as an isolated defect or associated with any syndrome.
When should you get it treated?
It is required that these anomalies are treated on time to minimize their impact on the growth, development & function of the child. These surgeries aim to help children accomplish their full capabilities without being defined because of their facial deformities or dissimilarities.
Any abnormality in this area affects how the child speaks, hears, chews, swallows, and how their brain develops.
How can Kayakriti help your children?
Through reconstructive surgery, children born with clefts can get transformed. Having partnered with SMILE TRAIN we are working towards this transformation by providing well-equipped medical services to these families. It is a free cleft care program aiming toward the productive life of these affected CHILDREN.
A multidisciplinary team is required for the optimal management of such cases. Our Plastic Surgery department at Vivekanand Polyclinic &IMS, Lucknow is fully equipped with surgical as well as post- surgical management of these children. We have a team of experts for complete physical & emotional childcare led by the Department of Plastic, Craniofacial & Microvascular Surgery integrated with the departments of Anaesthesiology, Paediatrics, Speech Therapy, Orthodontics, and Ear/Nose/Throat.
At the Vivekananda Polyclinic & Institute of Medical Sciences, Dr. Amit Agarwal has been heading the department since 2015, as the Project Director, Smile Train. Under Dr. Amit Agarwal around 3000 Orofacial Cleft patients have been treated to date. Through this Smile Train Project, Dr. Amit Agarwal and his team have been able to provide free treatment to all these Orofacial Cleft patients.
What is the Cause of Cleft lip and palate in children
The specific cause is unknown, but it is mostly multifactorial.
- Genetic predisposition.
- Environmental or Nutritional Factors.
Risk Factors for cleft lip and palate
- Family History of Orofacial Clefts.
- Exposure to toxic medicines, alcohol, or drugs during pregnancy.
- Diabetes.
- Obesity.
What are the Challenges faced by children with cleft?
- Social isolation.
- Risk of severe malnutrition.
- Difficulty in feeding & breathing.
- Speech defects.
- Chronic Ear Infections.
Can Diagnosis of Cleft be made during the pregnancy period
YES-
- Prenatal Ultrasound - By the 13th week of pregnancy, Cleft Lip may be diagnosed using Prenatal Ultrasound. But an isolated Cleft Palate is difficult to diagnose prenatally.
- Amniocentesis - This fluid test indicates the presence of inherited genetic syndrome which may give rise to other birth defects.
How can Cleft Lip and Palate be prevented in children
- Genetic Counselling - This can help parents to be mentally prepared to face further challenges in their child. The genetic counselor can also help determine the risk.
- Prenatal Tests - This helps to determine the condition of the fetus.
- Avoid Alcohol & Tobacco Consumption - These substances have a teratogenic effect on the fetus if consumed during pregnancy.
- Consumption of Prenatal Vitamins - Prenatal vitamins are essential to meet the increased nutrient requirements of the body during pregnancy.
What are the benefits of Cleft Surgeries
- Reconstruction of damaged bone & tissues to restore their normal functions.
- Improves physical appearance making the patient more socially acceptable & building up the patient's self-confidence.
What are the different surgeries required for a cleft child
Cleft Lip/Palate occurs during the early stages of pregnancy, due to unfused tissues forming a gap involving the lip, palate, alveolus, or nose on single or both sides of the face. The treatment required depends on the involved area and its severity. Multiple surgical procedures may also be required in such patients.
The right chronology for the treatment-
To achieve the best results, the right surgery needs to be done at right time by an experienced team.
- Cleft Lip Surgery - 3 to 6 months
- Cleft Palate Surgery - 9 to 12 months
- Velopharyngeal Insufficiency Surgery - 3 to 5 years
- Alveolar Bone Grafting - 7 to 9 years
- Rhinoplasty (For Nasal Deformity) - 14 to 18 years
- Orthognathic Surgery (Repositioning of Jaw) - After 18 years
Other methods to reduce surgical requirements
To reduce a child's surgical treatment, we also use the Nasoalveolar Molding procedure to make the cleft smaller before surgery.
All the surgeries are done under General Anaesthesia. Postoperatively,
What can you expect during different surgical procedures?
Cleft Lip Repair (Cheiloplasty)
- Done at the age of 3-5 months of the child.
- The child should weigh a minimum of 5 kgs before surgery.
- Through incisions made on both sides of the cleft, flaps are created with the tissue which is then used to suture & close the slit or the opening present in the lip defect.
- The lip muscles are also sutured in the same way. The skin is closed with absorbable sutures.
Cleft Palate Repair (Palatoplasty)
- Done at the age of 9-10 months of the child.
- The roof of the mouth which includes the hard as well as the soft palate is rebuilt using a specific Palatoplasty procedure.
- The muscle attachment of the palate is corrected in this procedure.
- It is a very important surgery and should be done at the correct time because delay in this procedure may also affect the speech of the patient. Delayed repairs beyond 2-3 years can lead to speech defects in the child.
Velopharyngeal Insufficiency Surgery
- This surgery is done in children who have undergone Cleft Palate surgery and are facing speech difficulties with their growth.
- In these patients, Nasoendoscopy is performed to check the closure of the velopharyngeal region at the back of their throat while the patient is speaking.
- In case of an insufficient closure, this surgery is advised.
- This helps to improve the speech of the patient to a great extent followed by regular speech therapy sessions.
Alveolar Bone Grafting
- This surgery is specifically done in Alveolar Cleft patients for the eruption of the canine teeth.
- Due to the lack of bone in the canine region in alveolar cleft patients, the eruption of the canine tooth is affected.
- So, through this procedure, a bone graft from the iliac crest region is taken and placed in the cleft area.
- This guides the canine eruption.
- Hence it is essential to perform this surgery at the right time as delay in it may cause canine loss.
Rhinoplasty
- This is a cosmetic correction done for the improved aesthetic appearance of the nose.
- Since the nose plays a very important part in the facial aesthetic, it affects an individual's entire appearance and his/her personality greatly.
- In children with cleft, Nose deformity is present in almost 80 to 90% of the cases which leads to low self-esteem and confidence in such children.
- Cleft rhinoplasty is quite a very challenging surgery and is usually done at the age of 13 to 15 years in girls and 14 to 16 years in boys.
- The nose is given proper shape through the manipulation of cartilage and graft insertions as it helps uplift the nasal bridge and tip giving it a proper shape.
- It is a very technique-sensitive procedure to be performed by an expert surgeon. Dr. Amit Agarwal has performed more than 100 cleft rhinoplasty with good to decent results.
Orthognathic Surgery
- This is a corrective jaw surgery, which includes repositioning the upper or lower jaw for the aesthetic improvement of the facial profile.
- This surgery is an advanced procedure that is done after the growth spurt is complete in both boys and girls.
- This is a specialized cosmetic correction performed by Dr. Amit Agarwal.
- The Upper & Lower Jaw are repositioned according to the facial aesthetics keeping the dental occlusion in mind.
- This procedure may require orthodontic treatment before or after the surgery is performed for minor further corrections.
Orthognathic surgery includes
- Le Fort Osteotomy for upper jaw advancement- most commonly done
- Bilateral Sagittal Split Osteotomy for lower jaw setback
- Bi-Jaw Surgery for both the jaws.
- Genioplasty/ chin surgery for chin advancement.
Recovery after Smile Train Surgery
Post-Operative Complications
- There are a lot of things that can go wrong at any stage of surgery while operating on a Cleft child. We at Vivekananda Polyclinic &IMS, have an excellent team of anesthetists, pediatricians, and intensivists to take care of the children.
- Bleeding.
- Infection.
- Poor Healing.
- Widening or elevation of scars.
- Temporary or permanent damage to nerves, blood vessels, or other structures.
Dr. Amit Agarwal performs all his Smile train surgeries at Vivekananda Polyclinic and Institute of Medical Sciences, Nirala Nagar, Lucknow. He can be contacted there in room number 5 and 7 on all weekdays between 9 AM to 2 PM daily.
Shaping dreams through
Know your surgeon better
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
His Credentials
Three pillars of kayakriti
Privacy
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Trust
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
Safety
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
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Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
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