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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 cleft lip and cleft palate. He works with a team of specialists who also take care of facial clefts, such as a speech therapist, an oral surgeon, an orthodontist, and even a prosthodontist if necessary. There is no age limit for treatment of cleft lip and cleft palate at The Craniofacial and Plastic Surgery Center in Houston.

What Issues Are Caused by a Cleft Lip and Palate?

Cleft lip and palate issues can lead to many difficulties in adults. The most common 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 patients who are adults with a cleft lip and cleft palate include:

  1. 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.
  2. Nose – Typically patients with a cleft lip and cleft palate will have a nasal deformity causing airway obstruction as well as an unpleasing shape of the nose.
  3. 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.
  4. Jaw – Typically with a cleft of the palate there is a jaw deformity as patients mature and become older.
  5. Dental concerns – Missing teeth, discomfort, malocclusion (bad bite) and misalignment, and other orthodontic issues can lead to reduced quality of life. Many patients wear dentures, which can slip, cause friction, or become uncomfortable over time. They can also limit one’s dietary options.

Is It Possible to Improve Speech in an Adult with a Cleft Palate?

Yes, Dr. Payne works with speech therapists to help diagnose if surgery or further speech therapy will be needed to improve a person’s speech. Some adult cleft patients can 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. Surgery can significantly improve a person’s speech leading to listeners understanding them more clearly. But like with any reconstruction where muscles are involved, postoperative therapy is necessary with a speech therapist to retrain the muscles to further improve the quality of the speech.

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. 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 are:

  • Plastic and reconstructive surgery – to fix palatal fistulas (small hole in the roof of the mouth), hypernasal speech, deviated septums and breathing problems, clefts in the gums (alveolar), and lip or nasal contour and asymmetry
  • Dental/Orthodontic/Maxillofacial corrections – correct jaw underdevelopment, malocclusion, and crooked, misaligned, or damaged teeth
  • Speech therapy
  • Prosthodontics – dentures or dental implants
  • Genetic counseling
  • Psychotherapy

What Type of Surgery Can Correct Adult Cleft Nasal Deformity?

Cleft lip and palate repair covers a wide range of treatments. 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. This surgery can help reshape the nose and improve the nasal tip to align the nose creating 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 give added 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.

What Can Be Done for Adults Who Have a Cleft That Affects the Jaw and Teeth?

Adult cleft lip and cleft palate patients with jaw and teeth deformities require a team approach with a craniofacial plastic surgeon, an oral surgeon, an orthodontist, and even possibly a prosthodontist. Typically, the first step is with pre-surgical orthodontia performed by placing braces to align the teeth. Then a second stage is planned with virtual surgical planning to determine the best alignment of 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 therefore a prosthodontist can help create a custom denture implant that can be removed or one that can be more permanent with dental implants. Some patients need dental implants to replace gaps between the teeth, which can be performed by an oral surgeon.

Post-Operative Care Following Adult Cleft Lip Repair

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.

Do You Perform 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 specialize in various fields, ensuring each patient gets the high-quality care they deserve. We offer adult cleft lip and palate revision to 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).

Does Medical Insurance Cover Adult Cleft Lip and Palate Repair?

Yes, insurance companies typically will cover surgery for cleft lip and palate nasal deformities, because they are not a cosmetic procedure. Cleft lip and cleft palate is a congenital deformity and therefore it is a reconstructive surgery that can be performed to improve the appearance of the individual.

How Much Does Cleft Lip and Palate Repair 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.

Dr. Payne and his team of specialist 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.