Understanding Appearance Concerns in Young People With Cleft Lip ± Palate: A Photo Elicitation Study

ObjectiveYoung 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.DesignThis was an exploratory qualitative study using photo-elicitation during semi-structured interviews conducted virtually. YP provided 3 photographs of themselves they liked and 3 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 analyzed using Reflexive Thematic Analysis.Patients/ParticipantsThirteen YP aged 16 to 20 years (mean = 17.8), 10 females and 3 males, were recruited via a UK cleft charity. Two had a cleft lip only, 9 had a unilateral cleft lip and palate, and 2 had a bilateral cleft lip and palate.ResultsFour 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.ConclusionsThe 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.