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Babies born with unilateral cleft lip and palate often face issues such as a crooked nose, nasal septal deviation, and separation of the lip and palate bones. Current surgical repairs for cleft lip can immediately improve the shape of the nose and lips, while also correcting the nasal septal bend. Post-surgery, the overall facial symmetry can become quite noticeable.
While cleft lip surgery aims to achieve symmetry in the nose and lips, what happens as the child grows? Studies show that although the surgery provides initial symmetry, the bones on the affected side grow more slowly over four years. This leads to increasing asymmetry in the nose and lips, with the cheek and lower area on the affected side becoming more sunken, and nasal asymmetry worsening.
Research from 2005 by Liao et al. indicates that without surgery, patients with cleft lip and palate experience shorter growth in the upper jaw compared to typical individuals, resulting in a shorter midface. The forward growth is less pronounced, causing the upper lip to retract. These issues are present in untreated cases and can persist or worsen post-surgery, as noted in 2012 studies. The lower jaw may also undergo relative changes.
Regarding facial asymmetry patterns, two studies published in South Korea in 2022 and 2023 examined patients who had unilateral cleft lip and palate surgery. They identified various asymmetric patterns, but the majority (about 30%) showed no significant asymmetry, only minor misalignments.