We met with Lucy's cleft surgeon, Dr. Vicari, last week for a checkup and consult for her next surgery. We were given two options to repair her fistula. Do a bone graft in the next year with a man-made product called Actifuse, repairing and straightening her nose at the same time. This will give her several years to see if/how much her bone grows over the graft to seal it. Or we can put it off until she's between 8-10 years old and use bone from her hip and repair her nose at the same time.
We've decided to move forward next summer with the Actifuse in order to *hopefully* spare her the second surgical site on her hip. If the Actifuse fails, she can then have the hip bone taken at the later age but there's a good chance we won't need that at all. The earlier surgery on her nose is also better done prior to elementary school when children are much more apt to point out her crooked nose and make her feel badly about it. We've had a few questions already from some of her classmates but Lucy has handled it well, saying, "I had a cleft lip and it just bent my nose! Isn't it pretty!". She is such a positive, cheerful little girl!
This graft is to eventually allow her to have dental implants to fill in the missing teeth from her cleft. This will not happen until her late teens when her face has stopped growing. In the interim, she will wear flippers (retainers with false teeth) to fill in the gaps in her beautiful smile.
Our orthodontist shared the before and current photos of Lucy's facial transformation. It really is amazing to see how her face has changed from December 2012 to June 2014, all without surgery. All of the movement in her face/jaw has happened only with the use of her mouth and face jewelry.
These were taken December 2012, prior to any orthodontic appliances. You can see in the top right photo that she was unable to show all of her teeth when she said, "CHEESE!"
"As you'll see, her arches have rounded out nicely and her tongue now has plenty of room to fit up easily into her hard palate. I will just be maintaining the correction and nudge it wider and anteriorly as needed until you do the grafting; Lisa says you gave her the option to do now with synthetic bone, or later with hip bone…..she seems ready now."
So it looks like we're aiming for surgery right after her last day of school next June. It will be a 2 week recovery period (no swimming, low activity level) so we'd rather do it at the first of summer than at the end.