Understanding Appearance Concerns in Young People with Cleft Lip +/- Palate: A Photo Elicitation Study

Objective:
Young people (YP) with a cleft lip with or without cleft palate have expressed concerns about their appearance and image-sharing on social media. This study aimed to explore and understand YP’s concerns, views, and experiences regarding photographs of themselves.
Design:
This was an exploratory qualitative study using photo-elicitation during semi-structured interviews conducted virtually. YP provided three photographs of themselves they liked and three they did not, which were used to facilitate discussion of their appearance, thoughts, and feelings about their photographs, and social media. Interviews were transcribed and analysed using Reflexive Thematic Analysis.
Patients/Participants:
Thirteen YP aged 16–20 years (mean = 17.8), ten females and three males, were recruited via a UK cleft charity. Two had cleft lip only, nine had unilateral cleft lip and palate, and two had bilateral cleft lip and palate.
Results:
Four themes were developed: (1) Symmetry equals beauty, (2) Controlling and curating the image presented to others, (3) Acceptance with maturity, and (4) Connections can promote empowerment.
Conclusions:
The themes highlight the concerns that YP have with their appearance, how they present their self-image to others and how they can become empowered to embrace their cleft condition and support others. Results suggest cleft services should integrate psychosocial screening, peer support, and appearance-focused interventions to promote confidence and resilience in young people.