Introduction
Cleft lip and palate are among the most common congenital facial differences, affecting approximately 1 in 700 births worldwide. For families seeking expert surgical correction, Shanghai Ninth People’s Hospital has established itself as a global leader in cleft care, performing thousands of successful repairs annually with outcomes that rival the finest centers in Europe and North America.
This comprehensive guide explores the cleft lip and palate treatment program at Shanghai Ninth Hospital, detailing surgical techniques, the comprehensive care team approach, and why international patients—from neighboring Asian countries to distant continents—choose this renowned institution for their children’s care or their own adult cleft revisions.
Understanding Cleft Lip and Palate
What Is a Cleft?
A cleft occurs when the tissues that form the lip and/or palate (roof of the mouth) do not join completely during early pregnancy. The condition varies significantly:
Cleft Lip
- Unilateral (one side) or bilateral (both sides)
- Complete (extends to nose) or incomplete
- May involve the gum line (alveolar ridge)
- Affects feeding, speech development, and facial aesthetics
Cleft Palate
- Soft palate only, hard palate only, or complete
- Submucous cleft (hidden beneath mucosal lining)
- Affects speech, hearing, and feeding
- May require multiple surgeries over time
Combined Cleft Lip and Palate
- Most complex presentation
- Requires coordinated multidisciplinary care
- Long-term follow-up essential
Causes and Risk Factors
While the exact cause is often unknown, contributing factors include:
- Genetic predisposition
- Environmental exposures during pregnancy
- Maternal nutrition (folic acid deficiency)
- Certain medications during pregnancy
- Smoking and alcohol use during pregnancy
The Shanghai Ninth Hospital Cleft Care Program
A Legacy of Excellence
Shanghai Ninth Hospital’s cleft and craniofacial program represents decades of specialized focus:
- Founded in the 1950s: Among China’s earliest dedicated cleft programs
- 50,000+ cleft repairs performed to date
- International training center: Surgeons from 30+ countries trained here
- Research leadership: Pioneering techniques in Asian cleft care
Multidisciplinary Team Approach
The hospital’s cleft team includes:
Core Surgical Team
- Pediatric plastic surgeons specializing in cleft repair
- Oral and maxillofacial surgeons
- Otolaryngologists (ENT specialists)
- Neurosurgeons (for complex craniofacial cases)
Support Specialists
- Pediatric anesthesiologists
- Speech-language pathologists
- Pediatric dentists and orthodontists
- Genetic counselors
- Child psychologists
- Nutritionists
International Patient Services
For families traveling to Shanghai for cleft care:
- Multilingual coordinators (English, Japanese, Korean, Arabic)
- Medical visa assistance with expedited processing
- Family accommodation guidance near the hospital
- Cultural and religious sensitivity training for staff
- Telemedicine consultations for follow-up care
Surgical Treatment Timeline
Cleft Lip Repair (Cheiloplasty)
Timing: Typically performed at 3-6 months of age
Surgical Goals:
- Close the lip defect
- Restore normal lip anatomy and function
- Create symmetrical lip and nasal appearance
- Minimize visible scarring
Techniques Used at Shanghai Ninth Hospital:
Millard Rotation-Advancement
- Gold standard for unilateral cleft lip
- Creates natural Cupid’s bow shape
- Allows nasal floor reconstruction
- Excellent aesthetic outcomes
Tennison-Randall Triangular Flap
- Alternative for wide clefts
- Precise measurements for symmetry
- Good for bilateral repairs
Fisher Anatomic Subunit Repair
- Advanced technique for optimal aesthetics
- Precise alignment of anatomical landmarks
- Minimizes secondary deformities
Cleft Palate Repair (Palatoplasty)
Timing: Typically performed at 9-18 months of age
Surgical Goals:
- Close the opening in the roof of the mouth
- Separate oral and nasal cavities
- Enable normal speech development
- Preserve maxillary growth potential
Techniques:
Furlow Double-Z Plasty
- Reorients muscle fibers for better function
- Lengthens the palate
- Reduces risk of fistula formation
Von Langenbeck Repair
- Traditional approach for hard palate
- Reliable closure with minimal dissection
- Preserves blood supply
Two-Flap Palatoplasty
- Comprehensive repair technique
- Allows tension-free closure
- Preferred for wide clefts
Secondary Procedures
Alveolar Bone Grafting (Age 7-9)
- Places bone in the gum ridge
- Allows permanent tooth eruption
- Stabilizes the maxillary arch
- Typically uses hip bone (iliac crest) graft
Pharyngoplasty (As needed)
- Corrects velopharyngeal insufficiency
- Improves speech resonance
- May involve pharyngeal flap or sphincter pharyngoplasty
Rhinoplasty (Age 15+ or adult)
- Corrects nasal asymmetry
- Improves breathing function
- Often the final surgical step
- May be combined with septoplasty
Orthognathic Surgery (Late teens/adult)
- Corrects jaw misalignment
- Improves bite function
- Enhances facial balance
- Coordinated with orthodontic treatment
Cost Comparison: Shanghai vs. Western Countries
| Procedure | Shanghai Ninth Hospital | United States | United Kingdom | Australia | Savings |
|---|---|---|---|---|---|
| Cleft Lip Repair | ,000 - ,500 | ,000 - 5,000 | £5,000 - £10,000 | AUD 0,000 - 8,000 | 70-80% |
| Cleft Palate Repair | ,500 - ,000 | 0,000 - 8,000 | £6,000 - £12,000 | AUD 2,000 - 2,000 | 70-80% |
| Alveolar Bone Graft | ,500 - ,500 | ,000 - 2,000 | £4,000 - £8,000 | AUD ,000 - 5,000 | 70-75% |
| Secondary Rhinoplasty | ,000 - ,000 | 2,000 - 5,000 | £8,000 - £15,000 | AUD 5,000 - 0,000 | 70-80% |
| Complete Treatment Package | ,000 - 5,000 | 0,000 - 0,000 | £25,000 - £50,000 | AUD 0,000 - 00,000 | 75-85% |
Note: Costs include surgical fees, anesthesia, hospital stay, and initial follow-up. Extended accommodation for families is additional. Many charitable organizations also support cleft care at reduced costs.
Surgical Outcomes and Success Rates
Primary Repair Results
Shanghai Ninth Hospital publishes outcomes demonstrating:
- 95%+ successful lip closure with minimal complications
- 90%+ successful palate closure without fistula
- <2% major complication rate for primary repairs
- Aesthetic outcomes rated excellent in 85% of cases
Speech Outcomes
With proper palate repair and speech therapy:
- 80%+ achieve normal or near-normal speech
- Reduced need for secondary speech surgeries
- Early intervention improves long-term outcomes
Long-Term Follow-Up
The hospital’s comprehensive program includes:
- Annual evaluations through adolescence
- Coordinated orthodontic care
- Psychological support services
- Adult revision surgery when needed
Adult Cleft Care and Revision Surgery
Addressing Previous Repairs
Many adults seek care at Shanghai Ninth Hospital for:
- Revision of childhood repairs with suboptimal results
- Nasal deformity correction
- Lip revision for improved aesthetics
- Palatal fistula closure
- Orthognathic surgery for jaw alignment
Specialized Adult Techniques
- Scar revision with advanced techniques
- Cartilage grafting for nasal support
- Fat grafting for lip volume
- Orthognathic surgery with virtual planning
The Patient and Family Experience
Pre-Operative Preparation
For Infant Surgery:
- Nutritional optimization (weight gain protocols)
- Nasoalveolar molding (NAM) when indicated
- Parent education and counseling
- Anesthesia evaluation
For Older Children and Adults:
- Comprehensive medical evaluation
- Dental assessment and treatment
- Speech evaluation for palate patients
- Psychological preparation
Hospital Stay
Typical Duration:
- Cleft lip repair: 3-5 days
- Cleft palate repair: 5-7 days
- Secondary procedures: 3-7 days depending on complexity
Family Accommodations:
- Parent rooming-in options for infants
- Family waiting areas with amenities
- Breastfeeding support for nursing mothers
- Play areas for siblings
Post-Operative Care
Immediate Recovery:
- Specialized feeding protocols (breastfeeding support, special bottles)
- Pain management appropriate for age
- Wound care education for parents
- 24/7 nursing support
Long-Term Follow-Up:
- Scheduled return visits
- Telemedicine options for international patients
- Coordination with local providers
- Speech therapy guidance
Why Choose Shanghai Ninth Hospital?
Unmatched Experience
- Highest volume cleft center in China
- Specialized expertise in Asian facial anatomy
- Innovative techniques developed and refined here
- Training center for cleft surgeons worldwide
Comprehensive Care
- One-stop care from infancy through adulthood
- Coordinated team approach
- Research-driven protocols
- Family-centered philosophy
Cost-Effective Excellence
- 70-80% cost savings compared to Western countries
- High-quality outcomes at accessible prices
- Charitable care programs for families in need
- Medical tourism support for international families
Cultural Sensitivity
- Experience with diverse populations
- Multilingual services
- Religious and cultural accommodation
- Family-friendly environment
Planning Your Cleft Care Journey
For International Families
Step-by-Step Process:
- Remote consultation: Submit photos and medical history
- Treatment planning: Video consultation with surgical team
- Travel coordination: Visa support and logistics planning
- Arrival and evaluation: Comprehensive in-person assessment
- Surgery and recovery: Procedure with full family support
- Follow-up care: Coordinated with home country providers
Recommended Stay:
- Cleft lip repair: 2-3 weeks in Shanghai
- Cleft palate repair: 3-4 weeks in Shanghai
- Secondary procedures: 2-3 weeks
What to Bring
- Complete medical records and previous surgery reports
- Growth charts for infants
- Current medications list
- Comfort items for children
- Family support (recommended)
Conclusion
Cleft lip and palate repair at Shanghai Ninth Hospital represents the pinnacle of reconstructive surgical care, combining decades of specialized experience with innovative techniques and compassionate, family-centered support. For families seeking the best possible outcomes for their children—or adults seeking revision of previous repairs—Shanghai Ninth Hospital offers world-class expertise at a fraction of the cost found in Western healthcare systems.
The hospital’s commitment to comprehensive, long-term care ensures that patients not only receive excellent surgical results but also the ongoing support needed for optimal speech, dental, and psychological outcomes. In the hands of Shanghai Ninth Hospital’s experienced cleft team, children born with cleft conditions can look forward to normal, healthy lives with confidence and smiles.
Author: SeeDocInChina Editorial Team
Medical Reviewer: Dr. Zhang Jian, Department of Plastic and Reconstructive Surgery, Cleft and Craniofacial Center (Shanghai Ninth Hospital)
Last Updated: April 2026
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Cleft lip and palate repair involves surgical risks, and outcomes vary by individual. Consult with qualified specialists to determine the most appropriate treatment plan for your specific situation.
Image Sources:
- Hospital facilities: Shanghai Ninth People’s Hospital (used with permission)
- Anatomical illustrations: Public domain medical illustrations
Related Articles:
- Shanghai Ninth People’s Hospital: The Complete Guide to China’s #1 Plastic Surgery Hospital
- Rhinoplasty at Shanghai Ninth People’s Hospital: Asian Nose Reshaping Guide
- Changhai Hospital Shanghai: A Leading Center for Plastic and Reconstructive Surgery
References:
- Shanghai Ninth People’s Hospital Official Website: https://www.9hospital.com.cn/english/
- American Cleft Palate-Craniofacial Association (ACPA) Guidelines: https://www.acpa-cpf.org/
- World Health Organization - Birth Defects Factsheet: https://www.who.int/news-room/fact-sheets/detail/birth-defects
- Chinese Cleft Lip and Palate Treatment Guidelines: http://www.cmaplasticsurgery.org/