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.
| 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. |
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.
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:
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.
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.
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.
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.
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:
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.
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).
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.
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:
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.
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.
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.
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.
