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Paper short abstract

This paper examines how young women with cleft lip and palate in Medellín navigate the trajectory to rhinoplasty and what follows. It presents surgery as a threshold rather than an endpoint, complicating tensions between function and aesthetics, conformity and agency, and continued becoming.

Paper long abstract

For people with cleft lip and palate (CLP), medical intervention and social scrutiny begin at birth. This paper examines how young women with CLP in Medellín navigate the treatment trajectory leading up to rhinoplasty and what follows. Drawing on ethnographic fieldwork, it situates their experiences within a city where appearance is tied to femininity, desirability, and social recognition.

Using Van Gennep and Turner’s concepts of separation, liminality, and incorporation, alongside Shilling’s body project, the paper examines cleft treatment as a prolonged passage toward bodily and social change. Rhinoplasty complicates any clear distinction between functional repair and aesthetic modification: it may improve breathing while also changing how participants are seen and whether their faces are recognized as “normal.”

Positioned as the final surgery after years of treatment, rhinoplasty shaped participants’ lives long before it occurred. Although its timing was governed by facial growth and clinical sequencing, participants actively lived toward surgery through makeup, observing others further along in treatment, imagining outcomes, and seeking greater influence over its timing.

Rhinoplasty was anticipated as a moment when treatment, appearance, and self might finally align. After surgery, participants often described greater confidence and social ease, but incorporation was neither immediate nor uniform. The changed face could take time to become familiar, and reduced visibility of cleft did not erase participants’ histories. Some pursued further modifications, while others refused them.

The paper presents cleft rhinoplasty as a threshold rather than an endpoint: the culmination of a medical trajectory and the opening of continued becoming.