Use of Hyaluronic Acid Filler in Patients with Secondary Cleft Lip Deformity

Abstract

When considering the management of asymmetry, volume deficiency, scarring and vermillion notching following cleft lip repair, surgical techniques are commonly applied. However, surgery may not be suitable for all patients. Hyaluronic acid (HA) is a common, non-permanent filler widely used in non-surgical aesthetic practice. We present our unit's two-year experience of the regular use of HA filler in a dedicated Adult Cleft Facial Augmentation Clinic. Methods Retrospective case note review was undertaken of all patients treated in the clinic over a two-year period. Results 20 patients underwent HA filler injections to the upper lip 26 times. Most were female (F:M = 3:1) and patients were aged 18-58 years. Most patients had a unilateral cleft lip +/− palate (n = 13, 65%). The most common indication was to address upper lip volume (n = 13, 65%). Other indications included vermillion notch (n = 5, 25%), cupid bow peak height asymmetry (n = 4, 20%), scar asymmetry (n = 1, 5%) and nasal sill flattening (n = 1, 5%). Small volumes of filler were used with an average of 0.34 ml (range 0.05-1.2 ml). There were no complications and one patient reported pruritis post procedure. Conclusions HA filler is a safe and reliable treatment for certain aspects of asymmetry following cleft lip repair. It can be used to address volume deficiency and asymmetry, cupid bow peak height discrepancies and a vermillion notch for patients who do not want surgery. Injection of HA to the lips can be performed easily, with appropriate training, in the outpatient setting.