Craniofacial and Cleft Care

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We treat the full range of these craniofacial conditions, holding your child's hand and yours every step of the way.

At Cook Children's, we help babies, children and young adults across Texas with differences in the head and face. Our craniofacial and cleft specialists bring decades of experience and innovations to your child's treatment. Working together, team members deliver outstanding outcomes - even in challenging cases.

Learn more about:

Surgery for clefts - unwanted openings of the lips or mouth
Surgery for craniosynostosis - skull bones closing too early and preventing normal head growth

Choosing Cook Children's craniofacial and cleft care

We provide full care for craniofacial conditions to improve your child's health and well-being.

We tailor treatments and other support to your child's medical, social and emotional needs. We partner with you and your child to understand and achieve all goals.

At our program, you can expect:

Team approach: Experienced pediatric plastic surgeons direct our team of craniofacial specialists. This team-based approach ensures your child gets the best care possible - before, during and after surgery. It also lets us treat the most challenging problems involving the face and head. Meet our Pediatric Plastic Surgery team [link to team page].
Top surgeons: Our pediatric plastic surgeons are board certified and skilled in the latest techniques. They're leaders in their field, publishing research and lecturing worldwide to advance care. Our surgeons not only oversee your child's treatment, but they're also at their bedside. Their involvement helps your child feel more comfortable as they receive care.
Innovation: We use the latest, most advanced treatments and technologies for the best outcomes. For example, virtual modeling and 3D printing help our surgeons map out operations. This high-tech planning allows them to do procedures that weren't possible before. It also makes operations more efficient, shortening anesthesia use.
Complete care: Additional Cook Children's specialists are available to help your child with related needs such as feeding and speech. Our craniofacial team helps arrange visits as needed.
Convenience: You have direct access to our craniofacial and cleft coordinator to help schedule appointments, answer your questions, and save time. Whenever possible, the coordinator groups specialist visits together, to save you trips to see us.

Craniofacial differences we treat

Craniofacial conditions affect the soft tissues and bones of the head and face. Some are congenital (present at birth), while others come later from disease or injury.

Our craniofacial and cleft specialists provide complete care for the full range of these conditions, regardless of how they start:

Cleft lip and cleft palate

Cleft lip and palate (opening in the upper lip, roof of the mouth and/or soft tissue at the back of the mouth)
Facial clefts (opening in other parts of the face)
Velopharyngeal dysfunction (feeding, articulation and resonance disorders associated with craniofacial issues)

Craniosynostosis

Craniosynostosis related to genetic syndromes:
- Apert syndrome
- Crouzon syndrome
- Pfeiffer syndrome
- Saethre-Chotzen syndrome
- Other syndromes involving early fusion of head and face bones
Craniosynostosis that is isolated and non-syndromic

Eyes, nose and midface anomalies

Ear differences - prominent ears, constricted ears, Stahl's ear, microtia (underdeveloped ears)
Fractures of the midface and orbit
Nasal malformations
Orbital hypertelorism (wide spacing between the eye sockets)

Vertical or horizontal orbital asymmetry (eyes not lining up properly)

Jaw anomalies and injuries

Dental disharmony (misalignment between the jaw and teeth)

Fractures of the mandible (jaw)
Malocclusion (bite issues) and jaw growth anomalies

Named syndromes affecting facial structure and growth

Beckwith-Wiedemann syndrome (causes large tongue and other abnormal growth)
Craniofacial or hemifacial microsomia (affects the development of the ears, nose, soft palate, lips and jaw), which can also be a part of a larger condition known as Goldenhar syndrome
Nager syndrome (affects development of the cheekbones, jaw, hands and arms)
Parry-Romberg hemifacial atrophy (causes skin and tissues in half the face to shrink over time)
Pierre Robin syndrome (affects the development of the jaw, tongue and upper airway)
Stickler syndrome (affects the connective tissues)
Treacher Collins syndrome (affects the bones and tissues of the face)
Other syndromes involving differences in facial structure and growth

Skull differences other than craniosynostosis

Positional plagiocephaly (flat spot on the back or side of a baby's head)
Traumatic and post-surgical skull malformations

Tumors and vascular lesions

Dermoid cysts (noncancerous lumps that form near the skin's surface)
Fibrous dysplasia (bone disorder where scar tissue replaces healthy bone)
Neurofibromatosis (learn more about our Neurofibromatosis Clinic)
Hemangiomas (bright red or blueish birth marks formed by extra blood vessels in the skin)
Vascular, or blood vessel, malformations (learn more about our Vascular Anomalies Program)

Craniofacial treatments at Cook Children's

We determine your child's treatment plan based on personalized factors, including:

Age
Diagnosis
How the condition currently affects your child and how it may continue as they grow

We only recommend surgery if it will give your child the best chance for a great outcome. Some of our surgical approaches include:

Virtual surgical planning for improved outcomes

We make treatment safer and improve results by planning surgeries using virtual tools and physical models.

A craniofacial surgeon partners with an engineer to plan every step of the procedure precisely.

They work with software and images of your child, then print models, guides and implants tailored to your child and their specific surgery. Our on-site 3D lab helps make the process fast and smooth.

Your child's team then uses these customized tools during the operation. The tools help us achieve better results and even perform challenging procedures that weren't possible before. They also make surgeries more efficient, so your child spends less time under anesthesia.

Pediatric facial paralysis and nerve procedures

Sometimes, children are born with facial nerves that don't work right. At other times, accidents or treatment side effects can damage facial nerves. These challenges mean a child can't use facial muscles on a particular side, and the muscles lose tone and sag.

In the past, we could only help move tissues back into place. These “static” methods helped with appearance but still meant children couldn't move their muscles for things like blinking and smiling.

Our team now has the specialized expertise to perform innovative “dynamic” surgeries. These intricate reanimation surgeries "rewire" the nerves, some less than 1 millimeter wide. They may also rely on moving nerves or muscles from elsewhere in the body. We then bring in Rehabilitation specialists to improve appearance and function even more.

Managing related conditions

Craniofacial conditions are sometimes tied to other issues. Our program works closely with other specialties to meet your family's unique needs. Our partners include:

Behavioral Health (for psychology and psychiatry)
Ear, Nose and Throat
Feeding Therapy
Gastroenterology (for issues involving the digestive system)
Genetics (for conditions passed down through families)
Ophthalmology (for eye health and vision correction)
Oral surgery (for mouth problems)
Orthodontics (for dental issues)
Neurosciences (for brain and nervous system conditions)
Reconstructive Surgery
Pulmonology (for lung and respiratory conditions)
Radiology (for imaging)
Speech Therapy
Wound Care