Not much has changed surgery-wise for clefts since the mid 20th Century when I had my initial cleft lip and palate repairs. At least this is the case with regard to most closures of clefts. Cutting edge (no pun intended) treatments experiment with wires, retainers, and orthodontia-type contrivances to non-surgically pull the cleft palate together.

Cleft lip and palate are caused by abnormal facial development that occurs while the child is still in the womb.  The upper lip and roof of the mouth are incompletely formed, causing the clefts. They are among the most common birth defects affecting children in North America, according to the American Society of Plastic Surgeons (ASPS).   

A proud grandfather  has shared photos of his granddaughter’s progress after undergoing surgery for her cleft lip and palate.  I’m grateful to him and Dasher/Imgur/Daily Mail for these pictures and accompanying info.

In June of 2013, Lexi Grace was born with a severe cleft palate and lip.    

A proud grandfather has shared 18-month-old Lexi Grace's incredible progress after undergoing surgery for her severe cleft palate and lip 
 
Her grandfather writes that, although she suffered from discomfort and struggled with feeding, Lexi  was still ‘a happy baby’.
 
Wore a retainer with wires in her mouth.
 
Slowly Lexi Grace’s appearance began to change, according to her grandfather’s report on the online image community imgur.
After Lexi Grace reached 10 pounds, she had to have wires and gears inserted into her mouth for months that would begin to mechanically pull the gap together 

Wires to help reduce gap before surgery.

She wore a retainer with wires in her mouth for months that mechanically pulled palate together.

According to ‘poppy’, as his granddaughter now calls him, she wore the retainer and wires for months.

The baby then underwent surgery inside her 'mouth, on the lip and in her nose' to suture the two sides of the gap together. This is done by using tissues and muscles to rebuild the roof of the mouth 

Had cleft lip and palate surgeries.

After reaching 10 pounds, it came time for Lexi  to undergo a series of four surgeries to repair the lip and cleft.   In my day, the rule of ten was: “no surgery until a baby was at least ten weeks old, weighed ten pounds, and had a hemoglobin blood count of ten.”  My surgeon felt babies healed better, scarred less.

The first surgery involved suture together the two sides of the gap  which had split open her upper lip and nose. This involved matching up numerous muscles and tissues and sewing them together, layer by layer.

Lexi Grace's surgery was done by Larry A. Sargent, a plastic surgeon in Chattanooga, Tennessee

Months later, baby Lexi underwent surgery inside her mouth. Dr. Larry A. Sargent—a plastic surgeon in Chattanooga, Tennessee—did the work.. He closed the cleft  by fanning tissues across the gap to rebuild the roof of the mouth.

He did this by creating incisions that create flaps of tissue that are then stitched together, effectively closing the cleft.

Lexi Grace's recovery is not over yet. After her upper baby teeth grow in, they will need to be pulled so her 'upper gum line can be put in place'. But the pictures don't lie - she is all smiles

Meanwhile,  she is all smiles, according to her happy grandfather.

We wish her all the best.