Tag Archives: Plastic surgery

Belly Bulges

A protruding belly button is commoner in boys and may run in families   Everyone would love an eight pack abdomen, but for some it may remain just a dream. Their abdominal wall has unsightly bulges and protuberances, which may be a well rounded paunch or even hernia.

Some children have a protruding navel or belly button, which is noticed soon after the remnant of the umbilical cord falls off. When the baby cries or strains, the tummy bulges at the umbilicus. The swelling is called an umbilical hernia. It is commoner in boys. It may run in families and be associated with other diseases like thyroid deficiency or inborn errors of metabolism.

CLICK & SEE THE PICTURES

The foetus receives its nutrition through umbilical blood vessels that are attached to the navel. The abdominal muscles also fuse at that point. There is an area of weakness there which can cause a defect in the abdominal wall muscles. The intestines may protrude through this. Usually, the intestines can be pushed back when the child is quiet and lying down.

By the age of three or four years, the abdominal musculature develops and the hernia disappears on its own. It usually does not cause any symptoms till that time. If the skin over the hernia changes colour, or if the child starts to cry incessantly, consult a doctor. It may mean the intestine has got trapped in the hernia and its blood supply is being compromised, strangling the bowel.

Strapping the bulging belly button with plaster, tying it with a bandage or fixing a coin over it won’t help. On the contrary, it may be harmful as a piece of intestine may get caught in the bandage and stop the blood supply. This then becomes a medical emergency. If the hernia persists after the age of three, it needs to be surgically repaired.

Hernias can also suddenly appear near the umbilicus in adults. This “paraumbilical hernia” is situated just above the navel and occurs through a weakness in the abdominal wall muscles. It may be due to pregnancy, obesity or poor abdominal muscle tone. It may also appear if fluid accumulates in the abdomen as a result of kidney or liver disease. The hernia may contain fat or intestines.

Paraumbilical hernias that appear during pregnancy may disappear on their own. In others, they need to be surgically corrected, even if they are painless. Bits of bowel or other intestinal content can suddenly become trapped in them, precipitating an emergency. There is a band of fibrous tissue connecting and holding together the musculature of the two halves of the abdomen. If this is weak and separates out, it may cause a condition called “divarication of the rectus abdominus”. It is common in obesity. The affected area is usually long and stretches over the abdomen from the umbilicus to the rib cage. As the defect is large, the intestine does not become trapped inside. If there is no umbilical hernia, it can be left alone. Surgical repair is a variation of a “tummy tuck” and is done purely for cosmetic reasons.

If there is a small defect in the linea alba (fibrous structure running down the midline of the abdomen), a ping-pong ball sized bulge can occur at the spot. This is called an “epigastric hernia”. It needs to corrected.

About 75 per cent of hernias occur lower down in the groin area and are called “inguinal hernias”. They are commoner in men. They can extend from the lower part of the abdomen to the scrotum in men and to the labia in women. They are caused by a congenital defect in the abdominal wall. Some men push the contents of the hernia back into the abdomen and then use a “surgical truss” to hold it there.

The surgical treatment of hernias has changed over the years. Traditional techniques involved opening the abdomen and suturing the muscle layers. Hospital stays were prolonged and recovery slow. Now, laparoscopic repairs can be done, reducing the hospital stay to two or three days. Fine sterile surgical mesh can be used to cover the defect. The hernia is then less likely to recur as there is no tension on the layers of the abdominal muscles.

Some hernias can’t be prevented. Congenital abdominal wall defects are less likely to manifest as hernias if

• The BMI (body weight divided by height in metre squared) is 23

• Core strengthening exercises (oblique sit ups, plank position) are done daily

• Lifting heavy weights is avoided

• Weight-lifting exercises are done after proper training and conditioning.

Source: The Telegraph (Kolkata, India)

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Breasts Like a Woman

Both men and women have breasts. In women they are well developed while in men they are rudimentary. Yet 60 per cent of men, at some point in their life, develop aesthetically unacceptable “gynaecomastia “ , a term which in Greek means “breasts like a woman”.

Male babies may develop enlargement of one or both breasts. Sometimes, the affected breasts may also secrete a watery milk-like secretion. This is normal and occurs because the baby’s breast has been influenced by the mother’s hormones. It disappears if left alone. Pressing it to remove the milk can result in infection and abscess formation.

Thirty to 50 per cent boys in the age group 11 to 14 years suddenly develop breasts. It occurs because during this time the levels of the sex hormones, both estrogen (female hormone) and testosterone (male hormone), start to increase. Testosterone controls male traits such as muscle mass and body hair, while estrogen controls female traits, including the growth of breasts. A perfect ratio has to be maintained, or else it might lead to the development of breasts in boys. In 75 per cent of them, the breasts regress spontaneously within three years.

Breast enlargement in boys may persist because of hypogonadism (inadequate development of the male sex organs). This may be genetic — in people whose genetic profile is XXY instead of XY, owing to the failure of the testes to develop at all, or a result of artificial removal of the testes (castration). It may occur in adults as a result of kidney and thyroid diseases. Liver damage can also result in low testosterone levels and enlarged breasts.

Enzymes belonging to the cytochrome P450 group, found in fat tissue, convert testosterones to estrogens. As the fat tissue increases gynaecomastia can occur. Weight loss and exercises, like the bench press and push-ups, can correct this type of breast enlargement along with overall weight reduction.

These enzymes can be affected by medications for ulcers, anti psychotic drugs, sedatives, diuretics and some antibiotics. Long-term use of medications belonging to these groups can cause gynaecomastia. Several illicit drugs are available on the streets today. Some, such as the amphetamines, are touted as a “safe” adjuvant to long hours of studying as they prevent drowsiness. But long-term use of these not only damages the psyche but also promotes breast development.

“Nutritional supplements” are used by many bodybuilders. Many do not contain all the ingredients listed. Some are sold secretly “under the counter” or via the Internet. Many preparations are not legal or may have expired. They may not conform to safety standards. Moreover, they may contain steroids. Sometimes, they contain creatinine, natural ingredients found in the human body. However, they may be dangerous to health, and cause enlarged and sometimes lumpy breasts.

There is no short cut to a “Mr World” physique. At least two hours of workout is needed with a healthy high-protein, low-fat diet.

Gynaecomastia is not always harmless. It needs to be reviewed with all previous medical documents, and investigated with blood tests and scans. Very rarely, gynaecomastia confined to one side may be due to cancer.

Diagnosis and treatment of the underlying cause of gynaecomastia may lead to improvement. Changing the offending medication, avoiding alcohol and exercising regularly may be all that is required. Some medications which are anti estrogen, or testosterone derivatives can sometimes be used on a short-term basis under medical supervision. These medications are for treating other diseases and are not universally approved for the treatment of gynaecomastia.

Medical treatment or “waiting and watching” can be tried for two to three years. After that, the breast tissue tends to harden and then surgery is the only alternative. There are several options — liposuction, gland excision, skin sculpture, reduction mammoplasty or a combination of these techniques. Reduction surgery is a cosmetic procedure and is usually performed by plastic surgeons.

In 25 per cent of men with persistent gynaecomastia, there is no correctable cause, nor is the condition dangerous. If they do not wish to have surgery or try medications and just wish to live with the condition, the breasts can often be compressed. An elastic girdle worn by women around their abdomens can be used and works quite well. Or else, a loose thick shirt may be sufficient to hide the offending bulges.

Source: The Telegraph (Kolkata, India)

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Just what is it about moobs?

The number of men having breast reduction operations in the UK is rising dramatically, but is this really the result of the media spotlighting the physical flaws of male celebrities?

click & see

This is an era when glossy magazines and tabloids delight in the most minor flaw of the female celebrity.

The actress with bags under her eyes, the singer with an untrimmed armpit, the model with a sweat patch, all are presented blinking in the paparazzo’s flashbulb as their imperfections are chronicled.

All are highlighted with red circles and magnification. And the same process has been applied to male celebrities in recent years

When both the then Prime Minister Tony Blair and leader of the opposition David Cameron were pictured enjoying the sun in the summer of 2006, newspapers from tabloid to broadsheet passed comment on their “moobs”.

Every man has breast tissue, but some have excessive breasts. This ranges from classical cases of gynaecomastia, prompted by a range of causes, to breasts enlarged entirely by deposits of fat over the pectoral muscles. But whatever the cause British men seem to be increasingly concerned over the state of their chests.

The latest figures from the British Association of Aesthetic Plastic Surgeons (Baaps) seem to bear out this obsession.

Surgeons carried out 323 male breast reduction procedures in 2008, up a staggering 44% from 2007.

EXCESSIVE MALE BREASTS
*Pubertal gynaecomastia, common in boys, sees breast tissue grow due to hormonal imbalance

*In most boys it disappears by end of puberty

*Breast growth can be side effect of drugs used to suppress prostate cancer

*Can be caused by genetic condition like Klinefelter’s Syndrome

Other causes include:
*Obesity

*Anabolic steroid use

It would be easy to assume that the UK is a nation where men are rapidly becoming more obese, and they are taking a surgical shortcut to get rid of male breasts that are merely deposits of fat on top of their pectoral muscles.

But this is not the full picture says consultant plastic surgeon and Baaps member Dalia Nield.

She concedes that anything up to a third of the men seeking breast reductions are simply obese. But she says the rest of the rising numbers of operations are people who are suffering gynaecomastia – excessive breasts – caused by other factors, such as a hormonal imbalance.

Among these, a common type is pubertal gynaecomastia, where boys develop the excessive breast tissue during adolescence.

Many of those young men if they don’t have a very marked gynaecomastia they don’t necessarily seek help,” says Ms Nield. “But I see many of these pubertal cases later in life when they put on weight and it becomes more obvious.”

Genetic disorders like Klinefelter’s Syndrome – having an extra “X” chromosome – also account for some cases, and there are a rising number of men suffering from excessive breast tissue as a side effect of drugs prescribed for prostate cancer. Treatment of this type of cancer has improved in recent years, says Mrs Nield, leading to more cases.

But how can one explain the dramatic upwards trajectory for male breast reduction procedures? In 2005, only 22 were performed.

‘Tremendous distress’

Mrs Nield suggests that much of the increase may be due to the media publicising the surgery option.

Many of those pieces mocking the imperfections of the middle-aged celebrity also contain a factbox that talks about non-obesity gynaecomastia and explains that surgery is an option.

MOOBS: THE ETYMOLOGY
*Portmanteau word of “man” and “boobs”

*First reference in UK newspaper in June 2004

*Satirical website manboobs.co.uk domain name registered in January 2003

*Term assumed to be of US origin

The effect, Mrs Nield suggests, is that men who might have been suffering in silence for years, realise they are not alone and are spurred on to seek out surgery.

“It is a cause of tremendous distress,” says the surgeon.

And there is no doubting that the last few years have seen an increasing attention to this particular physical flaw.

A search of the LexisNexis newspaper databases suggests the word made its debut in a British newspaper in June 2004. Since then it has been used 161 times. There have been more than 350 references to “man boobs” over the same period. “Moobs” clocks up 281,000 hits on Google.

Kerri McPherson, a chartered health psychologist at Glasgow Caledonian University and a member of the men’s health group, Scotland, is an expert on male body image.

“I would argue that what the media is really discussing is just representing the growing concerns of everyday men. This concern has always been there but they have not been able to articulate it.”

And it could be argued that media mockery reinforces the negative body image of the excessive male breast sufferer, it also might free some from isolation and paranoia that they could have been burdened with a decade ago.

The presentation of “moobs” as something suffered by a slew of male celebrities might make life easier for the ordinary bloke sitting in a pub discussing his problem with his mates.

“More and more people are being given a language to talk about concerns about their body,” says Dr McPherson.

“Particularly with what is a very feminine [characteristic] if a man was talking about [having] breasts [decades ago] they would have been a source of ridicule.”
Paula Singleton, a researcher in the health faculty at Leeds Metropolitan University, is doing a PhD on the attitudes shown by men planning to have breast reduction surgery, entitled “Bruises heal but moobs last forever – men’s account of cosmetic surgery for gynaecomastia.”

“It seems like you can hardly turn on the telly and open a newspaper without it being mentioned,” she says.

“[Those planning surgery] described feelings of shame, anxiety and embarrassment. They had suffered everything from being shouted at from a bus to teasing from work colleagues… doctors smirking and laughing at them and saying ‘get down the gym’.”

Of course, it would be wrong to group men with excessive breasts into justifiable “moobs” – ie a hormonal, chemical or genetic cause – and unjustifiable “moobs” – those caused primarily by obesity.

Both sets of men may be suffering psychologically at a time when the male body is under increasing scrutiny.

In the academic world, most of the theorising about body image has traditionally been about women, but now researchers are starting to look at changing attitudes among men.

“Men are starting to feel those appearance pressures more and more,” says Ms Singleton.

And this growing body consciousness could lead to more men making their way through the surgeon’s doors.

Sources:BBC News: 28th.Jan.2009

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Some Health Quaries & Answers

Towering disturbance:-…....CLICK & SEE

Q: I own a flat on the third (top) floor of a building. The residents’ association has leased out the terrace to a cell phone company which has erected a tower there. I have a pacemaker and am worried about the impact of the signals from the tower on my heart. What should I do?

A: Signals from microwaves and cell phones do affect pacemakers. Irregularities in the heart rate have been noticed when a phone is held even 15cm away from the pacemaker. When you are living just under a phone tower, the signal is likely to be strong and powerful. The first symptoms of the pacemaker being affected are a feeling of faintness and irregularity in your pulse rate. You can be fitted with a 24-hour monitoring device by your cardiologist. This will document any irregularity, so you know it is real and not psychological.

If there are any changes, it may make sense to move. Your building association is unlikely to cancel a financially lucrative enterprise and get the tower relocated.

Circumcise to protect:-

Q: I read that circumcision offers protection against AIDS. I wonder if I should get my one-year-old son circumcised.

A: Circumcision is a surgical procedure that involves removal of the skin and mucosal tissue that covers the glans, the tip of the penis. Circumcision is unconditionally practised by Jews and Muslims. It is a part of their religious culture. In others it is usually performed if the foreskin gets stuck (phimosis) or infected. It does help in the prevention of AIDS and other sexually transmitted diseases. But it does not give 100 per cent protection.

All operations can have complications. Problems like infection or bleeding, though rare, can arise after the surgery. Unless your son’s paediatrician has advised circumcision for a particular reason, it does not make sense to put him through elective surgery. When he is older, teaching him about responsibility, sexual norms and safe sex may be a better option.

Yellow vs white:-

Q: There are natural and “artificial” eggs available in the market. The colour of the yolk in the two differs. Is there a difference in their nutritive values? Is eating eggs healthy?

A: Eggs contain easily digestible proteins, fats, vitamins and antioxidants. They are a complete food in themselves. The recommended intake is one egg a day for those with a normal lipid profile (cholesterol and triglycerides). If the lipids are raised, cutting down on yolks to a maximum of two per week would be fine. Egg whites do not add to the cholesterol level, and you can eat as many of these as you like.

The colour of the yolk only depends on the type of feed the hen has received. It does not affect the egg’s nutritive value. By natural eggs, I think you mean those laid by hens that roam free, and by “artificial” the ones that are laid in hatcheries. Nutrition-wise, both are the same.

Music mania:-

Q: My daughter listens to music the whole day. I don’t like it, but do not want to put a stop to it unless it is harmful.

A: If your daughter is listening to music instead of doing her homework or studying, perhaps you need to interfere. But do check her academic performance first. Listening to music does have many positive effects. It soothes, pacifies and relieves tension in children and in adults. Music during exercise provides a cognitive boost, in addition to the other benefits of regular activity. Loud music, on the other hand, can damage hearing, increase the heart rate and produce paradoxical excitement.

Unequal feet:

Q: My shoes never fit both the feet perfectly. One is always a little loose or tight.

A: A person’s feet may not be identical in shape and size. One is usually marginally larger than the other. If this difference is marked, footwear will never fit properly. It is better to buy a bigger size and wear two socks on the foot that is smaller. Otherwise, you have to buy two pairs of shoes.

Cauliflower ear:

Q: I pierced my ear in the upper part, in addition to the ear lobe. It has become red, swollen and painful. My ear now looks ugly and deformed. What should I do?

A: The condition you are describing is called “cauliflower ear”. It occurs when a blood clot develops in the cartilage of the ear as a result of injury. The accumulated blood becomes infected and this destroys the cartilage, making it shrunken and shrivelled.

As soon as there is pain and swelling owing to an injury (even piercing), it should be treated with ice packs and antibiotics. Once it becomes misshapen, cosmetic reconstruction by a plastic surgeon is the only option.

Sources: The Telegraph (Kolkata, India)

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Cleft Lip And Plate

What is cleft lip and palate?
At around six weeks of pregnancy, your baby’s upper lip and palate develop from tissue lying on either side of the tongue. Normally these tissues grow towards each other and join up in the middle.

When the tissues that form the upper lip fail to join up in the middle, a gap forms in the lip. Usually, there will be a single gap below a nostril (unilateral cleft lip). Sometimes there are two gaps in the upper lip, each below a nostril (bilateral cleft lip). When the palate fails to join up, a gap is left in the roof of the mouth, going up into the nose.

About half of all clefts involve both the lip and palate. About 2 in 10 are of the lip alone and 3 in 10 are of the palate alone. Of clefts that involve the lip, 8 in 10 are unilateral and 2 in 10 are bilateral.

A clear upper lip and palate are among the most common defects in babies and affect about 1 in 700 babies in the us. These conditions may occur singly or together and are present at birth. both conditions are very upsetting for parents, but plastic surgery usually produces excellent results.

………….CLICK & SEE

The defects occur when the upp & SEEer lip or roof of the mouth does not fuse completely in the fetus. In many cases, the cause is unknown, but the risk if higher if certain anticonvulsant drugs, such as phenytoin, are taken during pregnancy or if the mother is a heavy drinker. cleft lip and /or palate sometimes run in families.

If a baby is severely affected, he or she may find it difficult to feed at first, and, if the condition is not treated early, speech may be delayed. Children with a cleft lip and/or palate are also susceptible to persistent buildup of fluid in the middle ear that impairs hearing and may delay speech.

Cleft lip and cleft palate, which can also occur together as cleft lip and palate are variations of a type of clefting congenital deformity caused by abnormal facial development during gestation. This type of deformity is sometimes referred to as a cleft. A cleft is a sub-division in the body’s natural structure, regularly formed before birth. A cleft lip or palate can be successfully treated with surgery soon after birth. Cleft lips or palates occur in somewhere between one in 600-800 births. The term hare lip is sometimes used colloquially to describe the condition because of the resemblance of a hare’s lip. The Chinese word for cleft lip is tuchun , literally “harelip.”

Cleft lip
If only skin tissue is affected one speaks of cleft lip. Cleft lip is formed in the top of the lip as either a small gap or an indentation in the lip (partial or incomplete cleft) or continues into the nose (complete cleft). Lip cleft can occur as one sided (unilateral) or two sided (bilateral). It is due to the failure of fusion of the maxillary and medial nasal processes (formation of the primary palate).


.
.Unilateral incomplete..….Unilateral complete..…..Bilateral complete

A mild form of a cleft lip is a microform cleft. A microform cleft can appear as small as a little dent in the red part of the lip or look like a scar from the lip up to the nostril. In some cases muscle tissue in the lip underneath the scar is affected and might require reconstructive surgery. It is advised to have newborn infants with a microform cleft checked with a craniofacial team as soon as possible to determine the severeness of the cleft. The actor Joaquin Phoenix is an example of a person with a microform cleft that did not require surgry.

Cleft palate
Cleft palate is a condition in which the two plates of the skull that form the hard palate (roof of the mouth) are not completely joined. The soft palate is in these cases cleft as well. In most cases, cleft lip is also present. Cleft palate occurs in about one in 700 live births worldwide.

Palate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a ‘hole’ in the roof of the mouth, usually as a cleft soft palate). When cleft palate occurs, the uvula is usually split. It occurs due to the failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine processes (formation of the secondary palate).

The hole in the roof of the mouth caused by a cleft connects the mouth directly to the nasal cavity.

A direct result of an open connection between the oral cavity and nasal cavity is velopharyngeal insufficiency (VPI). Because of the gap, air leaks into the nasal cavity resulting in a hypernasal voice resonance and nasal emissions. Secondary effects of VPI include speech articulation errors (e.g., distortions, substitutions, and omissions) and compensatory misarticulations (e.g., glottal stops and posterior nasal fricatives). Possible treatment options include speech therapy, prosthetics, augmentation of the posterior pharyngeal wall, lengthening of the palate, and surgical procedures.
………………..Pictures showing unilateral and bilateral cleft lip and palate

.Symptoms:
Feeding
Most babies with a cleft lip can be breastfed. However, some babies have difficulty creating a seal around the nipple and may not be able to breastfeed. A special squeezy bottle can be used for feeding and can help if the baby can’t suck hard enough. These bottles are provided by specialist cleft nurses and are also available from the support charity CLAPA (see Further Information).

Babies who find it difficult to feed may gain weight slowly at first. A specialist cleft nurse can give advice about changing the type of formula milk and other feeding issues.

Speech
Cleft palate can cause problems with speech. The size of the cleft is not an indicator of how serious speech problems are likely to be – even a small cleft can affect speech. Most children go on to speak normally after some speech therapy, although sometimes further surgery will be needed to improve palate function. Children with clefts can sometimes have nasal sounding speech.

Hearing

Children with clefts sometimes have hearing problems. This is because the tube that connects the ear to the palate (the Eustachian tube) can be affected. Having a cleft can increase the chance of developing a condition known as glue ear. This is quite a common condition in all children and occurs when thick, sticky fluid builds up behind the eardrum. It can cause temporary hearing loss. As part of surgery to repair a cleft palate, surgeons often put a tiny plastic tube (a grommet) into the eardrum so that the fluid can drain out.

Teeth
Occasionally, a cleft palate may also affect the growth of you child’s jaw and the development of the teeth. Looking after teeth well and having regular care from a dentist or orthodontist can minimise problems.

Your child may need to have extensive orthodontic treatment to make sure the teeth come through straight and in the right place. This may involve wearing braces, especially around the time the second teeth are coming through and during the early teens. Your child may also need to have some teeth removed to prevent overcrowding.

Causes:
There are many factors that hinder the joining up process of the lip or palate during a baby’s development. If you have had a child with a cleft lip or palate, your chance of future children being affected is increased.

However, doctors can’t reliably predict which pregnancies will be affected because cleft lip and palate is usually caused by a combination of genetic and other unknown factors. The unknown factors may include an illness during pregnancy or being exposed to certain substances such as tobacco smoke or certain medicines.

Treatment:
Specialist centres
Ideally, children with cleft lip and palate should be treated by a multidisciplinary specialist “cleft team” that may include surgeons, speech and language therapists, audiologists (hearing experts), dentists, orthodontists, psychologists, geneticists and specialist cleft nurses. Care and support of your child and the family should last from birth until your child stops growing at about age 18.

If you have a baby born with a cleft lip or palate, your maternity hospital should refer you to one specialist centre. Often they have specialist nurses who can visit you to provide immediate support and advice. This can be invaluable in the early days.

Surgery
The timing of surgery varies, but usually an operation to close the gap in the lip will be done about three months after the baby is born. Surgery to close the gap in the palate is usually done at about six months.

Both operations are done while your baby asleep under general anaesthetic and involve a hospital stay of 3 to 5 days.

As your child grows older, further surgery may be needed to improve the appearance of the lip and nose and the function of the palate. If there is a gap in the gum, a bone graft will normally be done when your child is between 9 and 12 years old. This will help their second teeth to anchor properly into the gum. Bone is usually taken from the hip or shin and grafted into the gap in the gum.

Prevention:
If you have had a child with a cleft lip or palate, you may be offered genetic counselling to find out the chances of your next child being affected. However, in most cases the most sensible approach is simply to aim to have a healthy pregnancy. Smoking and drinking alcohol have been shown to increase the risk of babies being affected, and can cause other birth defects.

Research has shown that taking a daily supplement of 400 micrograms of folic acid in the month before conception and in the first two months of pregnancy can help prevent cleft lip. This is the same amount of supplement recommended to reduce the risk of neural tube defects such as spina bifida.

It’s thought that certain medicines may slightly increase the risk of cleft lip and palate. These include anti-epilepsy medicines such as phenytoin (eg Epanutin) and sodium valproate (eg Epilim). Steroid tablets and a medicine called methotrexate (eg Metoject) that is used to treat some cancers and inflammatory conditions, such as rheumatoid arthritis, may also increase the risk. If you are on these medicines, you should discuss the benefits and possible risks with your doctor before trying for a baby.

Help and support:
If you are a new parent of a child who has a cleft lip or palate, or a child who was born with a cleft, a specialist psychologist working in the cleft team can help you cope with some of the challenges you may have to deal with. It can also help to get support from other people who have had have had similar experiences, either as parents, or as someone who has grown up with a cleft leaf.

Click for more knowledge & information:

www.clapa.com
www.changingfaces.org.uk
Cleft Plate Foundation
Best Way to Manage Cleft Lip and Palate

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

.Resources:
http://hcd2.bupa.co.uk/fact_sheets/Mosby_factsheets/cleft_lip.html
http://www.charak.com/DiseasePage.asp?thx=1&id=341
http://en.wikipedia.org/wiki/Cleft_lip_and_palate