The first step to helping improve the quality of your speech would be an assessment by a speech pathologist specialising in cleft lip and palate. They may recommend a nasendoscopy which would give a direct look at what is going on with your palate. The most common problem for patients with a cleft lip and palate is velopharyngeal incompetence, or VPI. This is where the palate does not close off the nasal cavity from the mouth properly, and allows air to escape. This can sometimes be improved with speech therapy but in many cases, surgery will be required. The nose can be improved with a septorhinoplasty procedure.
While a minor degree of facial asymmetry is not uncommon, there are many people who do have significant facial asymmetry, where either one side of the face overgrows, or more commonly, one side of the face is small. This is a spectrum from the very mild to the very severe. Management of this is best done in the setting of a multidisciplinary team such as a craniofacial unit, involving specialists from a number of different areas including plastic surgery, dentistry, orthodontics, otolaryngology etc. There is no quick fix and management requires treatment through to completion of growth. This may include orthodontics and jaw surgery to straighten the teeth and subsequent soft tissue surgery to improve the symmetry of the soft tissues. In severe cases, the orbits may also need to be repositioned.So in answer to your question, facial asymmetry can be managed and certainly be improved, it requires a comprehensive team approach to give you the best possible outcome
