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Cleft and Craniofacial Surgery

Services

Treatment offered by Cleft and Craniofacial Surgery is provided by a fellowship trained, board certified surgeon, Dr. Mechas, along with support and availability of a multidisciplinary team including speech and language therapists, pediatric dentists, orthodontist, head shape therapist, ear, nose and throat physician (ENT), and others. Emphasis is placed on long term patient care and at minimum yearly follow-ups through growth and development.

Full scope cleft lip, cleft palate, and craniofacial anomaly care is provided with a team approach and multidisciplinary coordination to address all of your child’s needs. This includes therapies and procedures throughout growth aimed at correction and coping with the cleft or facial deformity.

Surgical treatment includes primary lip and palate repair, distraction osteogenesis of the jaw and skull, speech surgeries, alveolar cleft bone grafting, corrective jaw surgery, rhinoplasty, temporomandibular joint (TMJ) reconstruction, dental extractions, treatment of head and neck pathology/tumors, and other facial and oral procedures.

Conditions treated include:

  • Cleft lip
  • Cleft palate
  • Pierre Robin Sequence
  • Syndromic conditions (Apert’s, Crouzon’s, Goldenhaar, Hemifacial Microsomia, Treacher Collins)
  • Craniosynostosis (skull deformity)
  • Jaw deformity
  • Malocclusions
  • Jaw joint problems
  • Velopharyngeal (speech) insufficiency
  • Oral and facial lesions, cysts, and tumors
  • Sleep apnea surgery
  • Dental implants and dental extrations

Scheduling

You call us at 901.448.6234.

Fax us at 901.448.2032

Locations

Dunn Building
875 Union Avenue
Memphis, Tennessee 38163

 

Referral Form

Helpful Patient Links

Frequently Asked Questions

  • Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth do not form properly.
  • These happen early in pregnancy, no one knows the exact cause
Examples of baby with cleft lip and palate.
From left to right; Baby with cleft lip, baby with cleft palate, close up of cleft palate.
  • Lack of fusion between median nasal process and maxillary process equal a cleft lip
  • Lack of fusion between palatal shelves and nasal septum equal a cleft palate

Description of diagrams is below under 'Diagram Description'.

Diagram Description
Top left is diagram a. Starting from top to bottom:
  • Frontonasal prominence
  • Maxillary processes
  • Oral cavity
  • Mandibular processes

Top center is diagram b. Starting from left most column to right, top to bottom:

  • Maxillary processes
  • Oral cavity
  • Mandibular processes
  • Medial nasal processes
  • Lateral nasal
  • Nasal pits

Top right is diagram c. Starting from top to bottom:

  • Alae

Top right is diagram d. Starting from top to bottom:

  • Primary palate
  • Nasal septum
  • Secondary palatal shelves

Top right is diagram e. Starting from top to bottom:

  • Primary palate
  • Secondary palatal shelves

Top right is diagram f. Starting from top to bottom:

  • Incisive foramen
  • Fused palate
  • Premature fusion of one or more skull sutures
  • Fusion restricts growth perpendicular to suture
    • Growth then occurs parallel to sutute to acommodate brain growth
    • This results in abnormal head and facial shape
    • Can lead to developmental delay and other neurological symptoms
Shows forms of craniosynostosis. See figure caption for details.
Shows the patterns of normal (green arrow) and arrested growth (red arrow) in the skull, leading to different forms of craniosynostosis. From top center going top left counter clockwise to top right: Normocephaly, Trigonocephaly, Brachicephaly, Anterior Plagiocephaly, Posterior Plagiocephaly, Scaphocephaly
Top view of a diagram of a baby's head with view of the skull. For details check the figure caption..
From top left in clockwise rotation: Lambdoid suture, Occipital bone, Parietal bone, Biparietal diameter = 9.5cm, Frontal bone, Metopic suture, Anterior fontanel, Coronal suture, Sagitaal suture, Posterior fontanel
Surgical Staging throughout Cleft Care
Stage Timeline
Lip repair < 6 month
Palate closure < 2 years
Pharyngoplasty (Speech Surgery) 4 – 6 years

Alveolar cleft bone grafting
When Eye Tooth (canine) is 2/3 formed

 7 – 12 years
Orthognathic surgery (Jaw Surgery) 14 – 18 years
Revision cheiloseptorhinoplasty
Final Cosmetic Lip and Nose Surgey		 17 – 20 years
  • Orthognathic, or jaw surgery, is surgery performed to correct combined skeletal (bone) and dental (teeth) malposition or deformity
  • Surgery performed using extensive planning in order to move the jaws in 3-dimensions
  • Typically performed when braces alone can't put the teeth into their ideal or best positions
  • Also used to improve facial appearance and profile
  • Fixes "underbites", "overbites", and open bites

Skull with plates and screws used during orthognathic surgery

Anatomical skull showing titanium plates and screws that might be used during orthognathic surgery.

Sideview of plates and screws used during orthognathic surgery.

Sideview of skull and face showing titanium plates and screws that might be used during orthognathic surgery.

 

 

Nov 1, 2022