Can My Cleft Lip Be Made More Symmetric In Size (Profile) To That Of My Lower Lip?
Q: Dr. Eppley, I was born with cleft lip and palate and am now 28 years of age. I would like to have more symmetry of my profile, which could be improved by either a bigger upper lip or smaller lower lip. I just feel as though I could look better than I do now now.
A: Thank you for sending your pictures. I do believe you are correct in that there is room for further facial improvement and symmetry. You have all of the typical lip and nose manifestations that I have seen in just about every adult patient affected by a cleft. By your pictures, you had a unilateral cleft lip and palate on the right side. The one thing that you don’t want to do is to make the lower lip smaller. That is the normal lip and it is better to focus on making the upper lip (the abnormal one) larger and more aligned to match better to the lower lip. In paired facial structures, it is rarely a good idea in the pursuit of symmetry to try and make the normal half look like the abnormal half. While I don’t have a good frontal view of your face, I suspect that the upper lip needs to be taken apart along the scar lines and reassembled with emphasis on achieving a better vermilion roll and pout. (cleft lip revision) There may even be some benefit to adding some upper lip volume through a dermal-fat graft or allogeneic dermis at the same time. It would also be possible to do a complete septorhinoplasty during the same procedure to treat the nasal component of the cleft as well.
Dr. Barry Eppley