Cleft revision surgery for cleft lip and palate
Specialist in secondary reconstruction of cleft lip and palate. Personalised treatment of problems with speech, breathing, feeding and facial appearance in children, teenagers and adults who have already had surgery.
What is cleft revision surgery?
Cleft revision surgery, for people born with cleft lip and palate, is a set of reconstructive procedures that correct the functional and aesthetic sequelae that can persist after earlier operations. Its aim is to restore anatomy, recover function and offer a new opportunity to improve quality of life.
Every patient has different needs. For this reason, Dr. Nico Sierra carries out a thorough assessment and designs a fully personalised reconstructive strategy, selecting different techniques to improve facial harmony and to optimise speech, breathing and feeding, always with a comprehensive view of the patient.
Revision surgery can be carried out at any stage of life, from childhood to adulthood; the most suitable moment depends on the type of sequela and on each patient's goals, within a multidisciplinary treatment coordinated with specialists in speech and language therapy, ear, nose and throat (ENT) medicine and orthodontics. Dr. Nico Sierra's extensive experience in cleft revision surgery makes it possible to recover function and harmonise facial appearance, strengthening self-esteem and quality of life, with natural results that are stable in the long term.
When is cleft revision surgery recommended?
Revision surgery can be indicated at any stage of life when functional or aesthetic sequelae of earlier reconstructive surgery persist; there is no age limit, and the most suitable moment depends on the type of problem, the patient's age and their goals. Many people born with cleft lip and palate — children, teenagers and adults — live for years with sequelae they consider unavoidable, such as aesthetic changes of the lip or nose, difficulties with breathing or feeding, or speech problems. However, it is never too late to feel better. After a thorough evaluation, Dr. Nico Sierra gives an honest, personalised opinion on the real treatment possibilities, combining different reconstructive procedures when this is beneficial for facial harmony, breathing, feeding and speech quality.
What is cleft revision surgery like?
People born with cleft lip and palate who have aesthetic and/or functional sequelae face different needs: treatment is planned in a personalised, multidisciplinary way, taking each patient's priorities into account. Each type of sequela — aesthetic changes of the lip or nose, or problems with breathing, feeding or speech — requires a specific reconstructive strategy; Dr. Nico Sierra selects and combines advanced, minimally invasive techniques to restore anatomy and recover function. The approach combines minimally invasive surgery with advanced anaesthesia protocols and enhanced recovery (ERAS), minimising postoperative pain and discomfort and allowing an early return to daily life. To achieve the best possible results, revision surgery is planned and carried out as part of comprehensive treatment, with the support of specialists in speech and language therapy, ENT medicine and orthodontics.
What results can you expect?
The aim of revision surgery is to restore facial harmony and recover the functions affected by the sequelae of cleft lip and palate. Depending on each patient's needs, reconstruction can improve the appearance of the lip, nose and smile, and optimise breathing, feeding and speech, contributing positively to self-esteem, social integration and quality of life. Dr. Nico Sierra's experience in cleft revision surgery allows him to adapt and combine different reconstructive techniques according to each patient's priorities, with a comprehensive approach that seeks natural, functional results that are stable in the long term — going beyond correcting anatomy, giving back confidence and supporting social interaction.
See all →Dr. Nico Sierra completed his fellowship in Craniofacial Surgery and Cleft Lip and Palate at the Federal University of Paraná (UFPR), Brazil. He is a reference surgeon at Clínica Tresserra and Vall d'Hebron University Hospital, and has taken part in surgical missions on four continents with Operation Smile.
His experience includes collaboration with Operation Smile on more than four continents, as well as the publication of a chapter with Springer on cleft lip and palate surgery in low-resource settings.
Frequently asked questions about cleft revision surgery
These are the questions families ask us most. If you cannot find the answer you are looking for, write to us directly.
Ask a question → When is cleft revision surgery indicated?
Cleft revision surgery is indicated when the aesthetic or functional sequelae of cleft lip and palate affect self-esteem, social interaction or quality of life. These sequelae can include changes of the lip, nose or smile, as well as problems with breathing, feeding or speech.
At what age can revision surgery be performed?
Revision surgery can be performed at any age. There is no age limit for looking or feeling better. Dr. Nico Sierra adapts the treatment plan to the stage of development, needs and priorities of each patient, and determines the most suitable moment for each operation.
What problems can revision surgery correct?
Revision surgery can correct or improve visible scars, changes of the lip, nose or smile, as well as problems with breathing, feeding and speech. Each treatment is planned individually according to the sequelae and goals of each patient. When it is beneficial, different reconstructive procedures can be combined in a single operation to improve appearance and function at the same time.
How many revision operations will be needed?
The number of revision operations depends on the sequelae present, the aims of treatment and each patient's priorities. In some cases the desired improvements can be achieved with a single operation; in others, it may be advisable to plan treatment in stages. Dr. Nico Sierra's aim is to design a reconstructive strategy that gives the greatest possible benefit with the fewest operations.
Is revision surgery more complex than the first operation?
Yes: revision surgery is usually technically more complex than the first operation, because it is performed on tissues that have already been operated on, with scars and anatomy altered by earlier surgery. For this reason, it requires broad, specific experience in cleft revision surgery. No single technique is valid for every patient: the reconstructive strategy is adapted to the anatomy, the previous operations and the functional and aesthetic goals of each case.
Can I have revision surgery if I was operated on in another country?
Yes: Dr. Nico Sierra frequently sees patients who were first operated on in other countries. The first consultation can be done remotely, reviewing photographs and the history of previous operations to advise on the real possibilities for improvement. The length of stay and the follow-up depend on each case.
Reviewed by Dr. Nico Sierra · Medical licence no. COMB 45307 · Reviewed: