Cleft lip and cleft palate together are the most common congenital deformity of the head and neck. The infant born with a cleft presents the reconstructive surgeon with a uniquely difficult surgical challenge— one that requires both aesthetic sense and technical skill to restore form and function. The complexity of the cleft deformity and the inexorable influence of facial growth also provide the surgeon with a uniquely rewarding opportunity to care for the cleft patient from infancy to young adulthood.

The history of cleft surgery reflects an evolution of techniques designed to improve surgical outcome. Despite the great advances in cleft surgery, many unanswered questions remain regarding the optimal timing and technique of surgical procedures that profoundly influence facial aesthetics, psychologic function, maxillary growth, dental development, and speech.