Although clefts of the lip and palate are operated on in infancy there can be long-term problems in terms of facial appearance, hearing defects, speech abnormalities and facial bone growth. Whilst hearing, speech and facial bone growth can be measured, limited success has been achieved in assessing facial appearance. We can gauge the length of the scar on the upper lip, we can calibrate the height of the lip vermilion on each side of the scar and to some extent we can quantify the degree of nostril deformity. However, from the patient and society’s point of view these measurements have little meaning.

The inability of surgeons to measure appearance encourages collaborations between the medical profession and others who have an expert knowledge of the human face to investigate different approaches to the problem. Visual artists comprise one such group and in 1997 a formal relationship was established between Stephen Farthing from the Ruskin School of Art and the surgeons and other team members from the Cleft Lip and Palate Unit at Guy’s and St Thomas’ Hospitals Trust in London.

The partnership examined how individual satisfaction with appearance during the course of cleft care has an important influence on wellbeing and whether the addition of artists onto a multi-specialty cleft team might further improve its clinical procedures. From the medical point of view, the collaboration gave patients a powerful tool in the field of patient-surgeon communication and provided them with a greater level of control over their facial image.

Commissioned by the Ruskin School of Art in collaboration with Guy’s and St Thomas’ Hospitals Trust and supported by funding from the Wellcome Trust.