A thoughtful staged reconstruction for the cleft lip and palate patient is the preferred approach. The primary lip and palate repair performed during infancy and early childhood provides the foundation for normal speech, occlusion, facial appearance, and self-esteem. A long-term negative effect of these early surgical interventions is a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws and dentition. This article reviews the variations in presentation, surgical and orthodontic techniques, and the results that we have achieved in patients born with a cleft who underwent primary repair in childhood, had a jaw deformity and malocclusion in adolescence, and underwent orthognathic surgery combined with orthodontic treatment for facial reconstruction and dental rehabilitation.