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Houston Cranio Facial

Adult Cleft Lip & Palate

Dr. Eric Payne is a craniofacial plastic surgeon who treats adults as well as children with craniofacial congenital deformities, such as a cleft lip and/or cleft palate. He works with a team of specialists who are highly experienced improving the quality of life for patients with facial clefts, such as speech therapists, oral surgeons, orthodontists, and even prosthodontists if necessary. There is no age limit for cleft lip and cleft palate treatment at The Craniofacial and Plastic Surgery Center in Houston, and we can help you improve many of the issues caused by these craniofacial deformities.

Quick Facts About Adult Cleft Lip & Palate Repair

Benefits Depending on your concerns, surgery and/or non-surgical treatment can help adults born with a cleft lip or palate improve their speech, achieve better jaw alignment, correct breathing issues, and cosmetically enhance scars or deformities in the jaw.
Surgery Time Adult patients may or may not require an overnight stay after surgery depending on the type of procedure performed.
Recovery Time If nose surgery or scar revision was performed, patients typically require one to two weeks of downtime. Most individuals who have minor jaw surgery can return to school or work after one to three weeks.
Healing Time In cases of surgery, healing is typically completed in about three months. Final results are usually seen at 9 – 12 months after swelling fully subsides, although the majority of inflammation often fades much sooner.
Post-Surgery Diet A liquid and soft food diet will be necessary for the first several weeks after surgery.
Why Surgery? Some adult patients born with a cleft lip and/or palate can benefit from surgery to improve cosmetic concerns, functional issues, medical conditions, or all of the above.
Cost The average cost of cleft lip and/or palate repair is $5,000 to $10,000 when a patient is working outside of an insurance network; some cleft-related procedures can be applicable for full medical insurance coverage.

Comprehensive Care For Adults Born with Orofacial Clefts

Those who were born with a cleft lip and/or palate can face unique challenges as they grow older, even if they underwent treatment or surgery to repair their cleft as a child. While not all patients who previously had a cleft require additional services, Dr. Payne and our compassionate team of specialists provide care and support for adult patients who are experiencing dental, physiological, functional, or cosmetic concerns related to their cleft lip or palate. Depending on the obstacles or complications you face, treatment may involve surgical procedures, non-surgical therapies, dental care, or some combination of the above. We use a collaborative approach to help ensure patients receive the best possible care for their specific needs, and can work with you to determine an optimal treatment plan to improve the issues caused by your orofacial cleft.

What Issues Can Be Caused By a Cleft Lip and Palate?

Cleft lip and palate issues can lead to many difficulties in adult patients. The most common problem is speech impairment to various degrees, but there are several other concerns that a number of people share.

Typically, areas that are of concern for adult patients with a cleft lip and cleft palate include:

  • Scar: Most people would like the scar on the upper lip to be revised and improved if possible, to try and hide the scar so that others may not notice it.
  • Nose: Typically patients with a cleft lip and cleft palate will have a nasal deformity causing airway obstruction, as well as a displeasing shape of the nose.
  • Speech: Some patients may have abnormal speech due to the cleft palate and would like to improve their overall speech quality so that others may understand them easily.
  • Jaw: Typically with a cleft palate, there can be a jaw deformity that develops as patients mature and get older.
  • Dental Concerns: Missing teeth, discomfort, malocclusion (bad bite) and misalignment, and other orthodontic issues can lead to a reduced quality of life. Many patients wear dentures, which can slip, cause friction, or become uncomfortable or ill-fitting over time. They can also limit one’s dietary options.

What Adult Cleft Lip and Palate Treatment Options Exist?

At our practice, we work with a comprehensive team of specialists who can address a wide range of issues affecting adult patients with cleft lip and palate concerns. Cleft lip and palate repair covers a wide range of treatments, including procedures to fix palatal fistulas (small hole in the roof of the mouth), hypernasal speech, deviated septums, breathing problems, clefts in the gums (alveolar), and lip or nasal asymmetry. Surgical and non-surgical options can be combined and customized to suit your individual needs. Some of the common treatments for adult cleft lip and palate include:

Plastic and Reconstructive Surgery For Nasal Deformities

Dr. Payne can perform a septoplasty along with a rhinoplasty to reshape the nose and open up the airway for easier breathing in patients who have a cleft lip and cleft palate. This surgery is called a septorhinoplasty and is done after teenage years. A septorhinoplasty can help reshape the nose and improve the nasal tip to align the nose and create more symmetry. The surgery on the nose and septum is done through an open approach, which means a small incision is hidden on the underside of the nose and inside the nose to provide better visualization of the cartilage deformity for repair. Sometimes, a rib graft is necessary to provide additional support to the nose in certain cases. Dr. Payne can evaluate you for a nasal deformity and discuss what is necessary to achieve the best result possible.

Close-up of nose and mouth with scar from cleft palate repair


Prosthodontics, or the dental specialty dedicated to restoring the health, appearance, and function of missing teeth, can help patients whose teeth or oral structures may not have formed properly due to their cleft lip and/or palate. If you have gaps in your teeth or an issue arising from the cleft is affecting your speech, appearance, or proper oral function, a prosthodontist may be consulted to place a dental implant, dental bridge, or set of implant dentures. These restorations are designed to mimic your natural teeth and blend in seamlessly with your smile. Prosthodontists can also create devices called “speech bulbs” or “palatal lifts,” which act like a dental retainer, to help seal the nose from the mouth and enhance speaking function.

Mouth with teeth visible

Dental, Orthodontic, or Maxillofacial Corrections

Adult cleft lip and cleft palate patients with jaw and teeth deformities—such as jaw underdevelopment, malocclusion, and crooked, misaligned, or damaged teeth—require a team approach with a craniofacial plastic surgeon, an oral surgeon, an orthodontist, and possibly a prosthodontist.

Typically, the first step involves pre-surgical orthodontics with braces to align the teeth. Then, a second stage with virtual surgical planning determines the best alignment for the jaw. Finally, jaw repositioning with possible bone grafting can be performed if necessary. Some patients do not want to undergo any further surgery and a prosthodontist can be enlisted to help create a custom denture, or a more permanent denture anchored by dental implants. Other patients may need dental implants to replace gaps between the teeth, which is a treatment that can be performed by an oral surgeon.

Mouth and nose, smiling with missing front tooth

Genetic Counseling and Psychotherapy

Our team of specialists can also provide or refer genetic counseling services to help you and your loved ones understand how a cleft lip and/or palate may affect your personal and family life. We can provide general education, support, and advocacy, as well as help you assess the risk of a cleft lip and palate as an inherited medical condition. Psychotherapy may also help patients cope with the emotional and psychological difficulties of a cleft lip/palate. Dr. Payne and his staff can help coordinate a referral if you need additional services.

Close up of DNA strand rendering, in blue

Speech Therapy

Dr. Payne works with speech therapists to diagnose whether surgery or further speech therapy is necessary to improve speaking problems. Some patients who previously had a cleft repaired may struggle with issues such as: 

  • Hypernasal speech
  • Sounds not forming clearly

Some adult cleft patients have nasal air escape or hypernasality from a condition called velopharyngeal insufficiency or VPI. The reason for the nasal air escape is due to the back of the throat not completely closing off the mouth from the nose. VPI is treated with surgery, which can significantly improve a person’s speech and help listeners understand them more clearly. But like any reconstruction involving muscles, post-operative therapy with a speech therapist is necessary to retrain the muscles and further improve one’s quality of the speech.

Woman in a yellow shirt in profile, pointing to her mouth

Adult Cleft Lip and Palate Revision

As a craniofacial plastic surgeon, Dr. Payne has extensive training in repairing conditions affecting the skull, face, and jaw. He also works with an experienced team who specializes in various fields, ensuring each patient gets the high-quality care they deserve. We offer adult cleft lip and palate revision for patients seeking an improvement in their facial appearance as well as their anatomical function. During your initial consultation, Dr. Payne can evaluate your concerns, develop a treatment plan, and provide additional information on how to correct the lingering issues associated with your cleft(s).

Woman looking ahead with mouth closed

What is Recovery From Adult Cleft Lip and Palate Repair Like?

The post-operative instructions for repairing an adult cleft lip and/or palate will depend on the type of surgery performed, how complex the treatment is, and other factors. Guidelines for care can include initial dietary restrictions (liquid or soft diet), reduced activity, pain management, and recommendations for maintaining dental hygiene without affecting the surgical site. Dr. Payne and his team will review the details of your post-operative plan in full with you before the surgery, and they will be available to discuss any questions you have about any stage of healing.

Can I Improve a Scar From Cleft Lip and Palate Repair?

It’s not uncommon for adult patients to have a visible scar left from their previous cleft surgery. In some cases, patients may also experience lip asymmetry or an irregular lip contour. There are many scar revision and plastic surgery techniques that can potentially improve facial scarring and/or balance the proportions of the lips. Depending on your concerns, a scar/lip revision procedure can:

  • Improve the appearance of hypertrophic (thick and wide) cleft scars
  • Change the shape/size of a scar
  • Restore symmetry in the lip contour

When correcting a scar or lip defect, Dr. Payne and our team aim to achieve results that look as natural as possible. For some patients, correcting asymmetries may only require a minor procedure or even non-surgical techniques. In either case, we will be able to present you with your treatment options after evaluating your concerns in a consultation.

How Much Does Cleft Lip and Palate Repair For Adults Cost?

Prices to repair or revise a cleft lip and/or palate will vary based on your individual treatment plan and the techniques that make up your procedure. Medical insurance should cover the cost of your treatment; however, if you are working outside of the health insurance industry, an operation of this nature can cost between $5,000 and $10,000. Dr. Payne and our medical team will provide details about fees associated with your program during your initial consultation, particularly if you plan to pay out of pocket. Everyone deserves to live the best life they can, which includes overcoming the difficulties caused by this condition. We’re here to help, so please reach out with any questions you have.

Additional FAQs About Adult Cleft Lip and Palate Repair

  • How do I know if I need care into adulthood?

    Some adult patients seek out additional support for their cleft lip and/or palate to resolve current issues they are facing, while others may not have received the best care or treatment as a child when their cleft was initially repaired. Questions that a patient may ask themselves when considering further care for a cleft lip/palate as an adult include:

    • What am I hoping will change?
    • What is my ideal outcome after treatment/surgery?
    • Do I have realistic expectations?

    While surgery should not be seen as a universal “fix” for the unique issues that patients who were born with orofacial clefts contend with, a continuum of care as an adult can potentially help individuals improve and uplift their quality of life. At any rate, rest assured that you will not have to grapple with the questions above on your own! Dr. Payne and our medical team will be available to discuss your hopes, concerns, and treatment options with you while going over the risks and benefits of treatment.

  • Does medical insurance cover nasal procedure costs for adults born with a cleft lip and/or palate?

    Yes, insurance companies typically cover surgery for cleft lip and palate nasal deformities because the procedure is not considered for purposes deemed “cosmetic.” A cleft lip and cleft palate are congenital deformities and, therefore, regarded as a reconstructive surgery that can be performed to improve the appearance of a patient. Our medical team will be available to discuss your hopes, concerns, and treatment options with you while reviewing the risks and benefits of treatment.
  • How common is a cleft lip/palate?

    Statistics from the CDC reveal that 1 in 2,800 babies in the United States is born with a cleft lip only, while 1 in 1,700 babies is born with a cleft palate only. A cleft lip with a cleft palate affects approximately 1 in 1,600 babies. Research has shown that orofacial defects, such as cleft lip and palate, rank high among the most common congenital deformities in the U.S.
  • How often is a cleft passed on to children?

    While genetic counseling can shed further light on the risk of passing on a cleft deformity, a family history of cleft lip and/or palate formation generally increases the likelihood of the condition affecting future children. Studies have indicated that a combination of genetics and one’s environment both contribute to the cause of a cleft lip and palate, although the exact cause is unknown.
  • Do all adults who had a cleft need further care?

    It is relatively common for adults who previously had corrective cleft surgery to experience speech, dental, and/or aesthetic concerns as they grow older, but not all patients born with a cleft lip and/or palate necessarily require further care. For adults who must contend with unique issues related to their cleft deformity, there are a number of services and resources available that can help improve one’s quality of life.

    Dr. Payne and his team of specialists can help you if you’re over the age of 18 and need further treatment for your cleft lip and cleft palate. Please give us a call to schedule your consultation.