Fillers to help adults with cleft lip have both positive and negative impacts | Columnists

Hello Dr. Kelly: Can fillers be used to improve a cleft lip in an adult?

Dr Kelly. Cleft lip is a birth defect present at birth in affected infants. The two sides of the lip that normally fuse during pregnancy do not complete this process. So, when the baby is born, there is a space in the upper lip between the left and right sides.

The initial approach must always be surgical. The operation is usually done around the age of 3 months, but some surgeons now prefer to do it even earlier. When cleft lip surgery is performed by an experienced surgeon, the results are often excellent. In some cases, the final appearance is so good that it can be difficult to tell that the surgery was even performed. Injectables such as hyaluronic acid should never be used to treat an unrepaired cleft lip.

But what about an adult whose cleft lip was repaired in childhood and who still has a residual deformity? Unfortunately, not all cleft lip repairs heal perfectly with a normal outline and a barely noticeable scar.

We use fillers in cosmetics to enhance the lips and correct asymmetries on a daily basis for aesthetic purposes. Why not use them to treat minor defects in someone who has a residual cleft lip deformity?

The answer is that it could certainly be done. If a patient with a cleft lip has less volume at the cleft itself, or if there is an asymmetry between one side of the lip relative to the other, fillers could theoretically be used to improve this.

It is important to remember, however, that fillers are temporary. It is both positive and negative. Fillers might be a good way to improve the appearance of the patient with a cleft lip in the short term, but they will eventually dissolve and so will have to be repeated. On the other hand, if the patient did not like the appearance of the filler, they could either wait for it to dissolve or dissolve it immediately with hyaluronidase.

In most cases, surgery performed by an experienced surgeon is a better choice. The surgery can often be performed under local anesthesia with minimal risk. It will produce a lasting effect and in many cases a small surgical intervention can produce a dramatic improvement.

In the patient below, we initially considered using a filler to add volume to her middle lip. But the patient really wanted to have a lasting result and instead of using a filler, I did a revision surgery under local anesthesia. The operation went well and he is still recovering, but he is already extremely happy with the result.

Fillers may be a good initial choice to help patients with residual deformity after cleft lip repair. But in most cases, revision surgery remains the best long-term approach.

About Dr. Kelly

Dr. Kelly is a board-certified plastic surgeon and partner of Miami Plastic Surgery and MPS Med Spa. He has been practicing for over 25 years and has been recognized by his peers nationally and internationally as one of the top plastic surgeons in the United States. In addition to being an expert in cosmetic surgery, his practice encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasounds, lasers and radiofrequency.

He also believes in giving back to our community, having served on the village council for eight years and volunteering as a coach for our youth sports programs. You can email him questions at [email protected]

Christine E. Phillips