Cleft Scar Aesthetics: Unregulated Filler Treatments Draw Criticism
Experts warn that adults with cleft lip scars are being targeted by the cosmetics industry, while patients cite the lack of standards as a barrier to care.
By Amit Ricci ·
Adults living with scarring from cleft lip surgery are increasingly turning to dermal fillers to improve the appearance of their features. This trend has prompted a debate over safety standards in a cosmetic sector that currently operates without government regulation.
Amber Dorgan, 20, from Neath, Wales, was born with a cleft lip and underwent five surgeries during childhood. She now receives free dermal filler for life through The Welsh Centre for Cleft Lip and Palate at Morriston Hospital in Swansea. Dorgan stated that the treatment has reduced her anxiety and allowed her to be more social. She said the fillers made her feel confident and helped her manage the insecurity she had since school, where she faced bullying over her scars.
Emily Evans, 21, from Kidwelly in Carmarthenshire, took a different path to treatment. After two surgeries, one as an infant and one at age 10, Evans was discharged from cleft services at 17 without an offer of filler. She discovered aesthetic practitioners in England and later found Summer Rose-Dorland, who runs a clinic in Somerset and holds pop-up sessions in Wales. Evans noted that she found a lack of practitioners specifically trained in cleft care within Wales. She joined CleftInject, a non-profit that connects adults with scarring to practitioners who understand the condition. According to Rose-Dorland, some CleftInject providers offer first treatments free of charge.
The rise in demand for these procedures has raised concerns among medical and psychological experts. Dr. Nicola Stock, an associate professor at the University of the West of England's Centre for Appearance Research, said that social media marketing is driving more people with clefts toward aesthetic treatments. She warned that individuals with complex medical histories are being deliberately targeted by the industry and left vulnerable to potential harm and exploitation. Stock noted that dermal filler has become one of the most common non-surgical cosmetic procedures worldwide, fueled largely by online promotion.
The UK lacks specific regulations for the aesthetics industry, creating uncertainty for both providers and patients. Rose-Dorland, who qualified four years ago and has completed 20 training courses, supports regulation. She argued that non-medical practitioners should be allowed to practice but must be subject to standards. She pointed out that doctors, nurses, and midwives often undergo similar training. Dr. Neil Brierley, a consultant cleft and plastic surgeon in the West Midlands, emphasized the importance of patients informing their NHS cleft teams about any aesthetic procedures. He explained that filler placement in certain areas can prevent future revisional surgery. Brierley stated that while individuals are entitled to choose their providers, it is critical to manage potential complications and maintain a connection to lifelong NHS care.
A cleft lip and palate is a congenital condition affecting one in every 700 babies born in the UK. It occurs when the upper lip or roof of the mouth fails to fuse during pregnancy. The condition can cause feeding, hearing, dental, and speech difficulties. Surgery to close the cleft is typically performed when a baby is between three and six months old. The NHS provides lifelong care for those with the condition, including speech therapy and surgical interventions.
Evans and Dorgan both agreed that increased visibility of people with cleft lips in public life would help young patients. Evans suggested that more people would consider filler if the option were better known. She said that while some people may prefer not to have filler to maintain their uniqueness, she believed the lack of awareness was a primary barrier. The Cleft Lip and Palate Action charity advises anyone considering treatment to contact their local NHS cleft team to research options thoroughly.
The debate centers on balancing patient autonomy with professional safety. Without a regulatory framework, it is difficult for patients to verify the qualifications of practitioners in advance. Experts recommend that individuals with clefts consult with medical professionals before undergoing non-surgical cosmetic procedures to ensure that any future medical needs remain addressable.
