In the surgical management of cleft lip and cleft palate, which defect is repaired first, and at what age is repair typically recommended?

The cleft lip is repaired before the cleft palate. Cleft lip repair (cheiloplasty) is typically performed at 3 to 6 months of age, guided by the Rule of 10s (infant should be at least 10 weeks old, weigh at least 10 pounds, and have hemoglobin of at least 10 g/dL). Cleft palate repair (palatoplasty) is performed later, typically at 9 to 18 months of age, to allow for palatal growth while still facilitating normal speech development. Early lip repair improves feeding, esthetics, and facial development.