International Craniofacial Institute

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International Craniofacial Institute

www.craniofacial.net Offering real hope to those with craniofacial differences, and offering a wide

At the International Craniofacial Institute, we specialize in treating:
Complex Craniofacial Conditions, Cleft Lip & Palate Repair, and General Pediatric Plastic Surgery

Full List of Services Offered

Craniofacial Conditions:

Craniosynostosis
Cleft Lip and Palate
Ear Anomalies / Microtia / Ear Wells
Encephalocoele
Eye and Orbit Anomalies
Jaw Anomalies
Nose Anomalies
Pierre Robin Sequence
P

lagiocephaly
Sleep Apnea
Tumors

Craniofacial Syndromes:
Apert
Carpenter
Crouzon
Down
Goldenhar
Hemifacial Microsomia
Muenke
Parry-Romberg
Pfeiffer
Saethre-Chotzen
Treacher Collins

General Pediatric Plastic Surgery:
Bumps, Burns, Dog bites, Lacerations, Lesions, Scars, etc. Other Treatments:
Adolescent Breast Reduction
Adolescent Gynecomastia Repair
Eyelid Deformities
Facial Trauma Reconstruction
Nasal Deformities or Trauma
Vascular Malformations

06/08/2026

Why does a bilateral cleft lip happen?

Most clefts are due to random chance in the first couple months after conception.

Normally there is nothing that the parents or families could have done any differently to prevent it. (Some things like smoking, alcohol, or other drugs, can slightly increase the odds.)

The premaxilla is the central part of the upper jaw. It extends from the forehead and nose, growing down from the frontonasal prominence.

From the sides, the lateral maxillary prominences come towards the middle to join with the frontonasal prominence.

When the lip doesn’t fuse on one side, a unilateral cleft lip is seen.

When both sides don’t fuse, a bilateral cleft lip occurs.

When the maxillary prominences don’t meet on the inside of the mouth, that is when a cleft palate occurs. (Specifically, of the secondary palate, the part posterior to the premaxilla.)

This sweet child is seen at 1 month after lip repair, eating well and thriving!
⁠.
‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠.
⁠ ⁠

06/01/2026

An “incomplete” cleft lip, meaning there is still a skin bridge, still requires full separation and dissection of the lip to fully repair the anatomy and minimize long-term asymmetries.⁠
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A few things I think about during this repair:⁠
⁠
Pic #2 – The white roll (at the border between the skin and dry mucosa) draws attention if there is a break in that light reflex, so creating continuity with good quality white roll is priority number 1 to reduce unwanted attention.⁠
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Pic #3 – The muscle fibers not only need to be repaired, they must be reoriented back to their original direction. This is similar to what we have learned from our cleft palate repairs, as the muscle action has a vector that should be returned to normal anatomic direction as possible. Judicious backcuts help to unfurl the muscle and bring the noncleft side down.⁠
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Pic #4 – The septal deviation is due to the muscle imbalance, with the noncleft side muscle pulling unopposed. The septum here is straightened without any resetting or unseating of the cartilage; rather, it was achieved by balancing the forces on the septum by releasing the muscle on that side.⁠
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Pic #5 – The release of that muscle can be achieved underneath and separately from the skin, so that the scar on the surface stays along the philtral column without adding scar at the base of the columella if one chooses.⁠
⁠
⁠
⁠
⁠
‭💻 craniofacial.net⁠⠀⁠
📱 ⁠
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠
⁠
⁠ ⁠

05/25/2026

One month after cleft lip repair, this girl is thriving.

Cleft lip repair is normally done between 3 and 6 months of age, though for the right patient, it is reasonable to discuss performing surgery at as early as 4 weeks of age.

Factors to consider include:
– prematurity, which increases the risk of apnea after surgery
– weight and feeding, to minimize risks of anesthesia and of postoperative problems
– width of the cleft, as additional nasoalveolar molding may be recommended before going ahead with surgery

Cleft lip surgery can safely be done as a same day surgery, though patients and families sometimes choose to be observed in the hospital overnight.

⁠
‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

05/18/2026

This sweet girl is one month after her cleft lip repair.

Normally surgery is done between 3 and 6 months of age.

This is a good balance when weighing anesthesia safety, scarring, activity level, and time to heal before the palate surgery.

Afterwards, children may continue breastfeeding or bottlefeeding the same as before surgery.

Most of our cleft lip patients also go home the same day after their lip repair.

After cleft palate surgery, patients usually stay 1 or 2 nights until we are confident the child is feeding well.

She has done beautifully, with a scar that will soften and fade over time.

⁠
‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

05/11/2026

This handsome patient was born with a complete bilateral cleft lip and palate.

He underwent repair of his lip at 3 months of age, and his palate repair at 9 months.

Repair of the orbicularis oris muscle early on helps to bring the central part of the palate and gums back in line with the rest of the gums over time.

He did also have some wider, thicker scars early on, and these improved gradually over time with massage and a steroid injection.

He is seen now, about to celebrate his 2 year birthday!

‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

05/04/2026

This lovely girl is seen at 6 months old after her bilateral cleft lip repair.

The first year for our families with cleft lip and palate are the busiest. This may involve NAM (nasoalveolar molding), cleft lip repair, and cleft palate repair.

The timing of these procedures take into account the normal milestones for growth and speech development, to give children the best chance to reach their potential. At the same time, we also aim to minimize the number of surgeries and exposures to anesthesia as we can.

Nothing makes us happier than seeing our patients thriving!

‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

04/27/2026

This beautiful girl is seen after repair of her bilateral cleft lip and palate.

The orbicularis oris muscle normally completes a ring around the mouth, allowing one to eat without food spilling out, and drinking through and straw.

In bilateral clefts, there is no muscle in the central portion, so the muscle must be brought all the way across from the sides.

This restores function, and helps to bring the premaxilla back in line with the lateral maxillary arches.

Elongation of the columella was also performed in the initial operation to reduce the flat and wide nasal appearance usually seen with bilateral cleft patients.

‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

04/20/2026

Our cleft cuties always bring a smile to our faces!

Repair of the orbicularis muscle of the lip guides the alveolus (or gum line) to realign and narrow the cleft, even in the absence of nasoalveolar molding (NAM).

Complete treatment of the muscle at the first operation is also key for preventing future problems.

Release of the muscle from the septum helps to reduce the deviation typically seen as patients get older, improving both breathing and appearance.

The lip scar and nasal symmetry will continue to improve over time, especially with optimal scar care and massage.

Thank you for trusting our team with the care of your loved ones!

‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

04/13/2026

This sweet girl is seen soon after her palate repair at 9 months of age.

Her primary lip and nose repair were performed earlier, for most patients usually at 3-6 months of age.

The cleft palate is then repaired usually in a single stage at 9-12 months, as babbling begins and speech development starts taking off.

This timing tries to balance scarring (which can restrict growth of the palate and midface), with optimizing speech development.

⁠
‭💻 craniofacial.net⁠⠀⁠
📱
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX⁠
⁠🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠
⁠

⁠ ⁠

Address

7777 Forest Lane, Building C, Suite 528
Dallas, TX
75230

Website

http://www.craniofacial.net/

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