All forms of hare-lip call for operation not alone for cosmetic purposes, but so that patients can nurse, drink, eat, and talk to better advantage. Obviously the earlier such operations are done, other things being equal, the better the results. When the cleft does not include the deeper tissues it may be closed within the first week or two of infancy. When the roof of the mouth is involved the surgeon is perplexed in deciding which is the better of two courses—to operate or to wait. Unquestionably by early closure of a fissured lip a gentle but constant influence is maintained to press the divided upper edges together, or at least to influence their more rapid growth toward each other. For this reason it would be desirable to operate early. On the other hand with a bad palatal defect it is a difficult thing to operate until, with the increasing age of the child, the mouth has attained a size which will permit the manipulations required for the purpose. Nevertheless, unless there be some special reason for delay it would appear wise, at least as a general rule, to operate early. (See [Cleft Palate].)
Fig. 448
Double hare-lip with philtrum or snout.
Fig. 449
Complete fissure, with labial defect and projecting intermaxillary. (Bruns.)
Fig. 450
Illustrating the osseous (palatal) defect in complete fissures. (Bruns.)