Q: Dr. Eppley, I am 37 years old and I was born with a cleft lip and palate. It has been repaired when I was a baby and child and I have had two operations, none past the age of three. I am wondering if anything further can be done to improve my appearance. I understand that due to the deformity, repair options are limited, as well as my age being a factor, causing healing times to be greater and results limiting. If possible I’d like to send pictures for a consult.
A: It is important to understand that age is not a factor in making healing times longer or in limiting the results from revisional facial cleft surgery. There is just as much that can be done for a 37 year-old as there is for a 7 year-old. The limiting factors, like in all cleft patients, is the magnitude of the original deformity and the quality and scarring of the lip, nasal, alveolar and palatal tissues. Since you have had but two surgeries that would suggest to me that there is room for improvement without even seeing your pictures yet. The influence of growth on the face makes for a lot of distorting changes around the orofacial cleft site. Even in the best of primary repairs as an infant, revisional surgery is almost always beneficial and desired in the teen years. It is very likely that there is room for visible improvement in the appearance of your external nose and lip through septorhinoplasty and a cleft lip revision.
Dr. Barry Eppley