title: Does repairing a cleft lip neonatally have any effect on the longer-term attractiveness of the repair?
abstract: OBJECTIVE
  To determine whether attractiveness and success of surgical outcome differ according to the timing of cleft lip repair.
  
  
  METHODS
  Three experiments were conducted: (1) surgeons rated postoperative medical photographs of infants having either neonatal or 3-month lip repair; (2) lay panelists rated the same photographs; (3) lay panelists rated dynamic video displays of the infants made at 12 months. Normal comparison infants were also rated. The order of stimuli was randomized, and panelists were blind to timing of lip repair and the purposes of the study.
  
  
  METHODS
  Four U.K. regional centers for cleft lip and palate.
  
  
  METHODS
  Infants with isolated clefts of the lip, with and without palate.
  
  
  METHODS
  Early lip repair was conducted at median age 4 days (interquartile range [IQR] = 4), and late repair at 104 days (IQR = 57).
  
  
  METHODS
  Ratings of surgical outcome (Experiment 1 only) and attractiveness (all experiments) on 5-point Likert scales.
  
  
  RESULTS
  In Experiment 1 success of surgical outcome was comparable for early and late repair groups (difference = -0.08; 95% confidence interval [CI] = -0.43 to 0.28; p = .66). In all three experiments, attractiveness ratings were comparable for the two groups. Differences were, respectively, 0.10 (95% CI = -2.3 to 0.44, p = .54); -0.11 (95% CI = -0.42 to -0.19, p = .54); and 0.08 (95% CI = -0.11 to 0.28, p = .41). Normal infants were rated more attractive than index infants (difference = 0.38; 95% CI = 0.24 to 0.52; p < .001).
  
  
  CONCLUSIONS
  Neonatal repair for cleft of the lip confers no advantage over repair at 3 months in terms of perceived infant attractiveness or success of surgical outcome.
authors.affiliation: Department of Plastic Surgery, Radcliffe Infirmary, Oxford, United Kingdom. tim.goodacre@orh.nhs.uk
authors.forename: Tim E E
authors.initials: TE
authors.lastname: Goodacre
authors.forename: Françoise
authors.initials: F
authors.lastname: Hentges
authors.forename: Tony L H
authors.initials: TL
authors.lastname: Moss
authors.forename: Vicky
authors.initials: V
authors.lastname: Short
authors.forename: Lynne
authors.initials: L
authors.lastname: Murray
mesh_terms: D000367:Age Factors; D002971:Cleft Lip / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019647:Oral Surgical Procedures; D017063:Outcome Assessment, Health Care; D010781:Photography; D019651:Plastic Surgery Procedures; D016037:Single-Blind Method; D014741:Video Recording