Are There Plastic Surgeons Who Work with Adults with Cleft Lip?

Most plastic surgeons, facial plastic surgeons (ENT), and pediatric surgeons are trained to do cleft lip, palate, and nose surgery, but not all continue to do them in their practices. Those that do ultimately gain experience in doing both lip and nose revisions, as their young patients' growth can cause unexpected changes in previously-operated areas. Some of these changes require surgical revision(s).

Now that adult age has been reached, changes are no longer occurring in your lip and/or nose. Prior surgery causes scar tissue, and the more there is, the more difficult the revision. (It may even be lucky that you didn't have a third surgery at age 12!) Hopefully, the initial surgeon(s) preserved as much tissue as possible, and now repositioning and adjustment with skilled technique and fine sutures will yield a better result. Each patient has uniques needs and previous scars, though yours (by looking at your photograph) seem fairly common.

Seek an experienced, board-certified plastic surgeon or facial plastic surgeon who continues to do clefts either in their everyday practice, or who has extensive experience in doing charity cleft surgery overseas. In my opinion, he or she should also have at least a decade of rhinoplasty experience, and continue to do lots of these surgeries in their regular practice. As an adult, you would no longer be a candidate for secondary surgery by a pediatric surgeon.

Cleft rhinoplasty is a challenging operation. I often will revise the lip at the same time as the scar can be advanced to make the nostrils more symmetric. I recommend seeing a surgeon who both performs a high volume of rhinoplasty and cleft surgeries. 

Cleft lip deformities all too often lead to the sequela you see.  The lip was lined up but the maxillary defect and the vermillion defect are obvious.  These would be corrected with a rhinoplasty.  Bone graft and cheiloplasty.