Truman William Brophy developed a cleft palate surgical repair, later called the Brophy Operation, in the late nineteenth century US. The procedure improved facial aesthetics and speech in cleft palate patients. A cleft palate occurs during development when the palatal bones in the roof of the mouth don't completely fuse, leaving an opening, or cleft, in the upper lip and mouth. Brophy's cleft repair used compression inside and outside of the mouth to push the palatal bones into normal alignment shortly after birth. Brophy advocated surgery on newborns with cleft palates as soon as possible after birth, which met with opposition in the late nineteenth and early twentieth centuries when medical professionals did not operate on infants for non-life threatening conditions. However, Brophy's successful operations convinced many doctors to adopt his technique.
Smile Train is a non-profit organization that Brian Mullaney and Charles Wang founded in 1999 in New York City, New York, that provides resources and trains medical staff in over ninety countries to give free surgeries to children in need of cleft repair. Clefts are birth defects that affect one in 700 children all over the world. They occur when the roof of the mouth, or palate, the lip, or both have a gap or split, because the tissues and bones did not fuse properly during fetal development. Surgeons typically repair clefts within the first year of life because clefts can often cause problems with eating, speaking, breathing, and hearing. Beyond providing cleft surgeries, Smile Train also supports the needs of children with clefts with services such as speech therapy, dental care, and psychological and nutritional support. Smile Train helps provide better access to cleft surgery and care for thousands of children worldwide, which improves the quality of life for people born with the developmental condition.