OBJECTIVE The purpose of this study was to examine preoperative to postoperative changes of soft tissue profiles in the midface of cleft patients who underwent maxillary distraction. METHODS Nine cleft patients were examined (distraction group). Lateral cephalograms were obtained preoperatively and 6 months after distraction. Changes in the positions of soft and hard tissue landmarks, the nasolabial angle, and facial height were investigated and compared with those in 9 other cleft patients who underwent conventional maxillary advancement (conventional group). RESULTS Anterior changes of the soft and hard tissue landmarks were significantly larger in the distraction group than in the conventional group. The distraction group tended to have larger increases in the nasolabial angle and subnasal length, as well as a higher anterior movement ratio for soft to hard tissue. CONCLUSIONS These results suggest that, in the midfacial profile changes of cleft patients who underwent maxillary distraction, not only is advancement of soft and hard tissue large, but also anterior movement ratio for soft to hard tissue is relatively high.