This is a congenital condition where the upper lip is cleft (separated) during the development. It can involve one or both sides. It can also involve a cleft in the alveolus and palate. The external deformity is aesthetically unacceptable to the parents and they would like it repaired as soon as possible. This is normally done at the age of 3 months or older provided the baby is healthy and developmental normal and fit. The cleft palate will cause problems in the speech and feeding. Liquid food will often regurgitate out through the nose and food debris would be stuck in the nose thus causing food decomposition leading to mouth and nasal odour. A middle ear infection is also common. It is wise to repair the cleft palate before the baby starts to develop his speech pattern. The best age is about 9 month but not later than a year or else it would be difficult to correct their established speech patterns. Immediate post-operative care must be taken after the operation as the closure of the cleft palate may hinder the breathing pattern. The patient is so used to an open passage and decreasing the space may cause some initial respiratory restrictions but this will improve shortly after the repair. For those with alveolar or palatal clefts, bone grafting is important for the dentition to be aligned. This is usually done at the age of 7 to 9 years after a period of orthodontic treatment. For some at the age of about 18-21 years depending on the sexual developmental growth, they may require orthognathic surgery to re-align the malocclusion of the jaws. This may be considered if early orthodontic treatment failed to prevent gross occlusion abnormalities. For some secondary corrections of residual nose deformities and revision of lip, scars may be necessary.