1801 Inwood Rd, Dallas, TX 75390 | (214) 645-2353

Adult Cleft Lip Revision

Adult Cleft Lip Revision


Cleft lip and palate are the most common congenital anomalies of the face and skull, affecting approximately one in 700 newborns in the U.S. Infants with cleft lip have variable degrees of change in the appearance of the lip and nose depending on whether or not the gums and palate are involved. When there is a complete cleft of the lip, gums and palate there is a wider separation in the bones of the gums and palate that creates a wide gap between the lip segments and drastically changes the shape of the nose. The standard timing for repair of cleft lip is during infancy. Today the cleft nasal deformity is frequently addressed as an infant also. Occasionally patients will have revisions of both the cleft lip and nose during childhood and/or the teenage years. Despite having a cleft lip repair, and maybe one or more revisions, it is not uncommon that patients are unhappy with the appearance of their lip or nose when they reach adulthood. In many ways these patients feel like a lost population because they do not know where to turn. Dr. Derderian frequently performs revision of cleft lips in children and adults. He also frequently combines lip revision with cleft rhinoplasty.

Dr. Derderian’s Goal for Your Cleft Lip Revision

Patients with significant scarring, lip asymmetry and/or abnormal lip contour after cleft lip repair seek revision to reduce unwanted attention and improve their self-esteem. Dr. Derderian’s goal is to provide a softer and natural appearance for patients with residual scarring or abnormal lip appearance due to cleft lip and palate. He approaches adult cleft lip revision and cleft rhinoplasty with the same meticulous attention to detail that he brings to cosmetic procedures. Dr. Derderian wants his patients to feel that people are focused on them and not their cleft lip by the end of their treatment.

Am I a Candidate For Cleft Lip Revision?

Cleft lip revision can be performed at any age. If you have reached skeletal maturity, that is age 16 for young women and age 18 for men, the primary consideration before proceeding with lip revision is if you need jaw surgery or not. The upper lip drapes across the upper teeth and changing the position of the upper jaw can impact the lip posture significantly, so it is better to wait until after jaw surgery to revise the lip. For older patients, you have likely completed orthodontic treatment and/or jaw surgery. Ideal candidates do not smoke, are in good health and have their medical issues well managed by their primary care physician. Cleft lip revision is frequently performed in conjunction with cleft rhinoplasty. Common reasons why people seek cleft lip revision include:

  • Poor scars in the lip after cleft lip repair
  • Uneven appearance to the upper lip
  • Imbalance between the bulk of the upper and lower lip
  • Deflated appearance to the entire upper lip
  • Decreased bulk in the center of the lip

What Happens at Consultation for Adult Cleft Lip Revision?

You will meet with Dr. Derderian to discuss your concerns about the appearance of your lip and the specific goals you have for improving your appearance. A complete history and examination will be performed to ensure that you are a good candidate for surgery. After verifying that you are a good candidate, Dr. Derderian will develop a customized plan tailored to your anatomy to achieve your goals for change. He will explain the plan in detail and answer all of your questions.

How is Adult Cleft Lip Revision Performed?

The procedure for cleft lip revision can vary dramatically. Small deficiencies of bulk or slight asymmetries may be addressed with very minor procedures. In some cases the result of the previous surgeries requires a complete re-repair of the lip that is as extensive as a primary cleft lip repair. The same strategies used for concealing scars in primary cleft lip repair are used in lip revision. The goal is to hide scars in the prominent features of the lip the generate light reflexes. If the scar follows the patterns of the normal anatomy of the lip the scars will be much less noticeable.

What is the Recovery of Cleft Lip Revision?

The lips are swollen after the procedure. Most of the swelling is resolved by 7-10 days after surgery. Sutures are usually removed at 5-7 days after surgery. Patients eat a soft diet for 1 week after surgery because it is more comfortable. Patients feel comfortable returning to school or work after 10-14 days. Normal exercise can be resumed after 2-3 weeks. Dr. Derderian recommends silicone gel application to the scars for 3 times per day for 4-6 months. Normal sun precautions are taken to protect the scars.

When is the final Result Appreciable?

While the symmetry and overall appearance of the lip is improved at 7-10 days after surgery, the final result is not appreciable until the scars have fully matured. The pink color leaves the scars at 4-6 months after surgery and the scars have fully matured between 6-12 months after surgery.

What is the Cost of Cleft Lip Revision?

Cleft lip is a congenital condition, therefore most insurance companies will cover treatment of cleft lip including adult cleft lip revision. Dr. Derderian’s staff will discuss the possible costs with you in detail. If your insurance does not cover cleft lip revision the costs will include:

  •  Anesthesia fees – cover the anesthesiologist, their staff and medications
  • Hospital or surgical facility costs – covers the operating room, staff and equipment
  • Surgeon’s fee

Why Choose Dr. Derderian?

It is critical to have an experienced surgeon perform your cleft lip revision. During his residency Dr. Derderian had extensive training in cleft lip surgery at New York University with Dr. Court Cutting, a world-renowned authority in cleft surgery. After completing his residency, Dr. Derderian did a fellowship in craniofacial surgery at the University of Pennsylvania and Children’s Hospital of Philadelphia where he received additional training in cleft lip revision. Dr. Derderian is board certified by the American Board of Plastic Surgery and is a member of the Cleft and Craniofacial Team at Children’s Health Dallas. He is the primary cleft surgeon for hundreds of patients with cleft lip and palate. He frequently performs primary cleft lip repair, cleft lip revision and cleft rhinoplasty in both his pediatric and adult practices. He is a nationally recognized authority in cleft surgery.

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