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Born with a cleft lip, Dorgan endured multiple challenges growing up, including hearing and speech difficulties along with bullying related to her visible scars. Throughout her childhood, she underwent five surgical procedures and attended frequent hospital appointments for speech and language therapy. Currently, she benefits from lifelong access to free dermal filler treatments provided by The Welsh Centre for Cleft Lip and Palate at Morriston Hospital in Swansea, a provision she deeply values.
Reflecting on her experience, Dorgan shared that she has always struggled with insecurities about her appearance and often felt anxious in social situations. She noted, “I’ve always been insecure about how I look, going out and about, I’ve always had anxiety and I just get nervous.” Receiving lip fillers has notably improved her self-confidence, helping to ease her anxiety. She expressed that this kind of treatment should be accessible to all individuals with a cleft lip as it significantly boosts confidence and happiness, recalling that prior to receiving fillers she was “really shy” and reluctant to engage with others or leave the house.
Evans came across information about available treatments through social media and discovered that aesthetic practitioners in England were offering procedures for people with scarring. However, she initially found a scarcity of such practitioners in Wales until she met Summer Rose-Dorland, who operates a clinic in Somerset and occasionally conducts pop-up clinics in Wales. After completing further training, Evans became involved with CleftInject, a nonprofit organisation that assists adults with cleft lip scarring to connect with aesthetic professionals knowledgeable about their needs. Rose-Dorland highlighted that many practitioners linked to CleftInject provide most treatments free of charge, especially for first-time appointments. She also mentioned that some individuals prefer aesthetic practitioners over NHS services because they perceive greater control over the final appearance of their lips.
The aesthetic industry currently lacks formal regulation, sparking debate about whether practitioners like Rose-Dorland, a non-medic with extensive training, should be permitted to administer treatments. Rose-Dorland, who qualified four years ago and has completed around 20 training courses, supports the introduction of regulations but believes non-medics should still be allowed to practice. She stated, “I’m a non-medic and I stand for having regulation, I generally think we need it in the aesthetics industry.” She also clarified that the training she received is shared by medical professionals such as doctors, nurses, and midwives.
Dr. Neil Brierley, consultant cleft and plastic surgeon with the West Midlands Cleft Service, emphasised the importance of people affected by cleft lip or their families maintaining contact with NHS teams, which provide lifelong care and support. He described the NHS as a source of “unbiased” advice to help individuals make informed decisions about treatments. Brierley cautioned against vulnerable patients seeking quick fixes outside the NHS without options for follow-up care available, stating, “What we don’t want is to have people who are potentially vulnerable who are looking for maybe a quick fix or a solution to feel that they don’t have an option to come back to the NHS.” He affirmed that while individuals are free to choose aesthetic treatments, they should be informed of potential complications and kept in communication with their cleft teams, especially since fillers could affect the feasibility of future surgeries.
Highlighting concerns about the absence of regulation in the administration of injectable treatments such as dermal fillers, Brierley noted ongoing efforts by global medical organisations to bring governance in line with government standards. However, he pointed out that “at the moment the entire field is unregulated,” making it difficult to determine which practitioners adhere to best practices. Dr. Nicola Stock, an associate professor researching the psychological effects of appearance-altering conditions, has been involved in studies assessing the use of dermal fillers among adults with cleft lips, their providers, and marketing strategies targeting this group. Her research indicates that many adults born with a cleft continue to have concerns about their appearance and show increasing interest in aesthetic treatments.
Stock expressed worry that marketing tactics, especially through social media, are driving a steady rise in the number of individuals seeking dermal filler treatments and that those with complex medical histories, such as cleft lip, may be “deliberately targeted” and vulnerable to exploitation. She urged those considering such procedures to thoroughly research their options and consult their local NHS cleft team or organisations like the Cleft Lip and Palate Action charity for guidance and support
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