Joaquin Phoenix was born with what looks like a type of scar between his lip and nose. It's actually a microform cleft, the mildest form of cleft lip.
Cheech Marin
Cheech Marin is one of Hollywood's most successful Latinos. Cheech and Chong's films and stand-up routines made audiences crack up in the 1970s and 1980s.
He has a scar on his upper lip, not from any orc action, but from his wild youth. “It was a combination of a fist and a barbed-wire fence on a particularly bad Hallowe'en night. I was 17. When I got out of surgery, my friends ordered pizza to the hospital and I helped them eat the pizza.”
Phoenix has never said he had a cleft lip or palate. In a Vanity Fair profile published in October, it was reported that his lip scar was “not a surgically fixed cleft, he says, but a nonsurgical scar he was born with.”
Cleft lip and cleft palate are thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy.
Although cleft lip with or without cleft palate can occur in any race, there is a higher incidence in people of Asian, Native American or Hispanic decent. There is a lower incidence in African-American individuals.
A cleft by itself is no considered a disability, though it may affect someone in a way which means they need extra support like hearing aids or ongoing speech therapy. In some cases, the extra support needed is substantial and long-term enough that it may be considered a disability.
The results of treatment for cleft lip and palate are usually excellent both aesthetically and functionally. Children born with these conditions have a good quality of life and a normal life expectancy.
Children with cleft lip and palate (CLP) also had an increased risk of ASD. Children with cleft palate only (CPO) presented with higher hazard ratios, and additionally for psychotic disorders, ADHD, and other behavioral or emotional disorders in childhood (Figure 1A−D, Tables S3−S6).
Cognitive deficits in syndromic clefting are frequent and often severe (mental retardation). The cognitive deficits associated with isolated clefts of the lip and/or palate (ICLP) are less severe, but the functional consequences of these deficits should not be underestimated.
The Western dietary pattern, eg, high in meat, pizza, legumes, and potatoes, and low in fruits, was associated with a higher risk of a cleft lip or cleft palate (odds ratio 1.9; 95% confidence interval 1.2-3.1).
Europe's incidence is about 1/1000; Asia and South Americas have relatively a high incidence of about 2/1000. Cleft lip and/or palate have the highest rates at birth in Asian (especially in China and Japan),3 and China is one of the regions with high incidence of about 1.663/1000.
The most common cleft type generally was the cleft lip, alveolus and palate cleft (CLAP) with a 434% prevalence of white patients and 296% of black patients.
Alcohol use during pregnancy may be a cause of isolated cleft lip with or without cleft palate.
Cleft lip and palate is a common birth defect. It occurs together in 1 of every 1,000 babies, somewhat more in males than females. About 20% have the cleft lip only, 30% have cleft palate only, and 50% of children with a cleft lip will also have a cleft palate.
1/700 people around the world will be born with a cleft lip and/or palate, though some statistics put it closer to 1/600. This is around 0.14% of the population.
Cleft chins are common among people originating from Europe, the Middle East and South Asia. There is a possible genetic cause for cleft chins, a genetic marker called rs11684042, which is located in chromosome 2.
Cleft lip and cleft palate are common birth defects. In the United States: About 1 in every 1,600 babies is born with cleft lip and cleft palate. About 1 in every 2,800 babies is born with cleft lip without cleft palate.
Indicators of lower socioeconomic status, such as lower maternal educational attainment and lack of prenatal care, are associated with an increased risk of cleft lip with or without cleft palate, according to a new study by researchers at Children's Hospital of Philadelphia (CHOP).
In a systematic review of 3 studies of orofacial clefts and caffeine, high coffee intake was associated with a slight increase in risk (11).
Maternal smoking is an established risk factor for oral clefts. A recent meta-analysis of 24 studies estimated that mothers who smoked during pregnancy had a 1.3 fold increased risk of having a baby with cleft lip with or without cleft palate, and a 1.2-fold risk of cleft palate alone.
Researchers believe the cleft condition is caused by a combination of genetic and environmental factors, which might include diabetes, obesity, consumption of cigarettes, alcohol or certain medications during pregnancy.
Genes such as those encoding transcription factors (e.g., TBX22, MSX1), growth factors (e.g., TGFA, TGFB3), and adhesion molecules (e.g., PVRL1) have all been implicated in the etiology of CLP.
Van der Woude syndrome is the most common genetic syndrome associated with cleft lip and palate, and is diagnosed in about 1 to 2 percent of children born with cleft lip and/or cleft palate. No differences in the incidence among races or gender have been described.