Will my child undergo surgery at this age to change their appearance?

Cleft surgeons usually suggest that patients wait until they have completed their growth before undergoing certain operations to change aspects of their appearance. Jaw and nose surgeries, for example, are typically performed during the late teen years, after a person has finished growing. But surgeons may also share information with families about operations that can be performed a younger age.

Which operations could occur at this age?

Lip Revision: A lip revision is an operation to change the shape of the upper lip in a person who underwent cleft lip-repair surgery earlier in life (usually during infancy). This procedure can involve evening out the proportions of the lip, making the lip look fuller, and/or helping the lip muscles work better during speech. A cleft-lip revision is considered “reconstructive” surgery, not “cosmetic” surgery. This operation does not usually require a night in the hospital.

Rhinoplasty: Nose surgery, called rhinoplasty, changes the shape of the nose and can improve breathing. Surgeons usually recommend waiting until growth is complete to undergo this procedure (called definitive rhinoplasty, during the teenage years), but some offer a “touch-up” procedure earlier in childhood.

Who decides whether to operate?

There is a growing body of research that shows that shared decision-making with regard to health decisions can benefit a child’s self-assessment and quality of life. Cleft professionals generally suggest that a child take on more and more independence as they grow, so that by the time they reach adulthood, they are making independent, informed decisions about their own health. This process starts in early childhood with age-appropriate participation, in coordination with caregivers and trusted professionals on the cleft team.

Citations:

American Cleft Palate Craniofacial Association. The School-Aged Years. ACPAcares.org. Accessed September 1, 2024. https://acpacares.org/resource-center/.

American Cleft Palate Craniofacial Association. As You Get Older. ACPAcares.org. Accessed September 1, 2024. https://acpacares.org/resource-center/.

American Cleft Palate Craniofacial Association. Parameters of Care For Evaluation and Treatment of Individuals with Cleft Lip and/or Palate and/or Other Craniofacial Conditions. ACPAcares.org. Published February 14, 2025. Accessed February 14, 2025.

https://acpacares.org/wp-content/uploads/2025/02/2024-ACPA_ParametersOfCare_Final.pdf.

Anishya D, Nagesh S. Assessment of Nasal Aesthetic Parameters in Patients with Unilateral Cleft Lip and  Palate – A Retrospective Study. The Cleft Palate Craniofacial Journal. 2024;0(0). doi:10.1177/10556656241261908

Napoli JA, Vallino LD; CCC-SLP; A; FASHA2. Achieving Excellence in Cleft Care: From Birth to Adulthood. Dela J Public Health. 2018;4(1):30-37. Published 2018 Jan 9. doi:10.32481/djph.2018.01.008

Sinko K, Jagsch R, Prechtl V, Watzinger F, Hollmann K, Baumann A. Evaluation of esthetic, functional, and quality-of-life outcome in adult cleft lip and palate patients. Cleft Palate-Craniofacial J. 2005;42(4):355-361. https://doi.org/10.1597/03-142.1

Wang X, Kuang W, Yan J, et al. Comparison of Facial Aesthetic Evaluation Given by Patients with Cleft Lip and/or Palate and Professionals: A Systematic Review. The Cleft Palate Craniofacial Journal. 2024;0(0). doi:10.1177/10556656241254186

Page reviewed by Matthew Hiersche, MD; ACPA Family Resources Committee