02/12/2026
Cleft Palate repair in a nutshell:
The palate is like a sandwich, with oral mucosa on one side, nasal mucosa on the other side, and in the middle is bone and muscle.
A lot of fistulas occur when the this mucosa is repaired, but the middle layer is missing bone in the front, and muscle gets swept towards the back, so there is a big middle area that doesn't have great blood flow, and mucosa flaps are hanging across this space.
Nowadays I use buccal fat flaps routinely to fill this space with vascularized tissue that supports the oral and nasal mucosa while each side heals, and additionally the fat will resurface with mucosa on its own if there is any mucosal breakdown.
Raw surfaces are minimal on the oral side, lessening pain and reducing secondary scarring that restricts maxillary growth. Hopefully we will see fewer and fewer patients requiring palatal expansion and jaw surgery, in addition to fewer fistulas and fewer surgeries for velopharyngeal incompetence.
A core goal is aiming for the fewest number of surgeries for our patients, while giving them the best possible function and appearance. That all begins with prenatal visits, NAM, and the very first cleft lip and palate repairs.
💻 lawplasticsurgery.com⠀
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👨⚕️ Dr. Huay-Zong Law
☎️ (214) 241-1997
📍 Dallas, TX
📍 Plano, TX
🏥 Board-Certified Plastic Surgeon
🎓 Craniofacial Fellowship Trained
