Cleft lip injections. Will you recommend? (Photo)

Question

I have a cleft lip, and my lips are asymmetrical. I’m thinking about lip injections to make them look better and more natural. I’m also having trouble closing my lips together and i can do some injections in my chin . Do you think it’s gonna work ? Will you recommend ? I don’t want to do any surgery at the moment.

George Volpe, MD · Answer

Following cleft lip surgery, many times there can be small little issues that affect symmetry of the lip. There can be small depressions or mismatch of certain parts of the lip. It is not uncommon for patients who undergo cleft lips surgery to undergo revisional procedures in the future. In general, one should wait 9 to 12 months following cleft lip surgery before considering a touchup. Certainly, fillers including both synthetic fillers and also one's natural fat which can be obtained elsewhere in the body and injected into the lip are alternatives. There are pros and cons of all various approaches if one requires a revision. A good discussion with your surgeon can help you understand the pros and cons of the different techniques. If your surgeon feels a surgical approach is best, he or she will let you know whether this can be done comfortably under local anesthesia. If you decide to have lip injections, it would be wise beforehand to have a discussion regarding expected results, the chance of sub optimal results and possible therapy if there are suboptimal results.

Robin Yang, MD, DDS · Answer

Cleft lip repairs and residual differences of the lip can be thought of in a few different categories that can also blend in together.
1. Deficiencies in Volume
2.  Alignment of the anatomical borders of the lip.  The vermilion (red Lip), White Roll, and lip mucosa (wet portion of your lip).
3.  Lip Projection
It is important to get the diagnosis correct as certain procedure may or may not address the correct differences.  
In my experience,  deficiencies in volume are best addressed with fillers or fat grafting.  I have found that I can be a bit more precise with fillers, however, they require upkeep, where as fat grafting is more permanent.  However, fat grafting does require a trip to the OR. 
Alignment issues are best managed with surgery and any amount of filler will not correct these issues with much patient satisfaction. These surgeries are often combined with some sort of lip volume augmenting technique such as Fat grafting or Dermal grafting.  
Lip Projection or being able to close your lips properly could depend on how your dentition or Jaw relationship is situated.  
In my experience having an evaluation with a provider that treats many of these cases is important to get the right diagnosis and long lasting result.

Sutton Graham II, MD · Answer

There are many individuals that have had a successful cleft lip reconstruction, who have mild to moderate degrees of asymmetry of the vermilion of the lip (the pink portions).  In the past various surgical procedure were used to improve this with variable results (reduction, dermal or fat grafts), but the availability of hyaluronic filler injections will make some of these operations unnecessary and achieve even better results.  Lip injections might be an excellent idea.Achieving lip closure is another issue.  Your best option should be to seek the advice of an experienced craniofacial plastic surgeon.  They may be found by contacting your nearest university medical center or through the American Society of Plastic Surgeons (plasticsurgery.org).

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