Surgical Considerations in the Adult

It is not unusual for functional problems related to the cleft to remain into adulthood. These may include speech problems, hearing problems, fistulas (small holes in the palate), dental problems, or breathing problems due to nasal obstruction.

You and your surgeon should agree about which, if any, of these problems should be dealt with first so that your long-term health and function will be the best it can be. 

Some of these problems may require the involvement of a variety of surgical, dental, or other specialists. This type of coordinated care is best delivered by a team of specialists who can address all problems that may be present after the initial repair of a cleft lip or palate.

Concerns about facial appearance after initial or primary cleft repair are more personal than functional (e.g., speech, chewing, swallowing) problems. Scarring, lip irregularities, and nasal deformities are probably the most common reasons you may seek later or secondary surgical correction. It is important that you understand exactly what is and is not possible, what the surgeon anticipates the recovery period to be and what, if any, limitations you will experience after the surgery is done.

Will insurance cover my surgery?

Insurance often does not cover the cost of aesthetic procedures, so it is important that you have a clear understanding of what your financial obligation will be before the procedure is done. Most surgeons who do secondary surgery feel that this type of surgery is reconstructive (to restore function) and not merely cosmetic (to improve appearance), because its purpose is to try to reconstruct the structures affected by the cleft. Increasingly, though, insurance companies are taking the position that these types of procedures are performed for cosmetic reasons only, and they are refusing to pay for some or all of the costs.

Download Information about Treatment for Adults for additional information, including:

  • Creating an attractive smile
  • Ear, nose and throat health
  • Working with insurance companies