Operation Smile

Operation Smile is an international nonprofit medical organization focused primarily on children and young adults born with cleft lip, cleft palate, and related facial conditions. Founded in 1982 by American plastic surgeon William P. Magee Jr. and his wife, Kathleen S. Magee, the organization began after the couple joined a volunteer surgical mission to the Philippines and encountered many patients who could not be treated because the visiting team was not scheduled to return. The Magees organized additional missions and gradually developed a permanent humanitarian medical organization. The organization’s central service is reconstructive surgery delivered through international medical missions and local care programs. Its work is supported by multidisciplinary teams that can include plastic surgeons, anesthesiologists, pediatricians, intensive-care specialists, nurses, child-development professionals, speech pathologists, dentists, and orthodontists. Before surgery, patients are assessed for medical suitability; after surgery, programs may provide follow-up care and referrals addressing nutrition, speech, dental health, psychosocial development, and other needs associated with facial cleft conditions. Operation Smile has described its work as extending beyond individual operations. It seeks to improve access to safe surgery by training local medical professionals, strengthening hospital capacity, developing standards for volunteer missions, and supporting care centers. The organization has held international meetings on medical standards and has established foundations and operational partnerships in several countries, including Australia, the United Kingdom, Italy, Vietnam, and Ireland. Its first permanent care center opened in Duitama, Colombia, in 1995. By 2022, the organization reported continuing care through 38 smile centers around the world. Since its founding, Operation Smile has reported providing more than 350,000 surgeries in over 60 countries, without charging recipients for the procedures. These figures encompass operations for cleft lip, cleft palate, and other facial deformities, although the organization’s public materials and outside descriptions may use differing accounting periods and definitions of care. Its model combines volunteer medicine, fundraising, corporate partnerships, public education, and long-term infrastructure development. The charity has also attracted scrutiny. In the late 1990s and early 2000s, reported patient deaths led to criticism of its medical procedures and organizational oversight. Operation Smile acknowledged shortcomings after an internal review and announced changes involving executive recruitment, the creation of a chief medical officer position, and stronger board supervision of volunteer medical staff. The organization later became involved in a proposed merger with Smile Train in 2011; the plan was announced and then abandoned within weeks. A related foundation was subsequently separated from Operation Smile and eventually became connected with Smile Train through Stop Cleft International. Operation Smile has used public campaigns and commercial partnerships to broaden awareness and fundraising. Examples include work with Hasbro around Mr. Potato Head, collaborations with Sephora and AriZona Iced Tea, a 2018 partnership with Lay’s, and a 2024 educational and fundraising collaboration with MrBeast’s Beast Philanthropy. It has also received public support from entertainers and cultural figures. The organization remains an active global medical charity headquartered in Virginia Beach, Virginia.

Operation Smile emerged from a volunteer cleft-surgery mission to the Philippines in 1982. William P. Magee Jr., a plastic surgeon, and Kathleen S. Magee, whose professional background included social work and nursing, joined a medical team traveling to treat children and adults with facial clefts. They found that the number of untreated patients greatly exceeded the mission’s capacity and learned that the visiting group did not plan to return. Rather than regard the effort as a one-time expedition, the Magees organized two further visits to Naga, where approximately 400 children received treatment. These return missions became the foundation of a continuing organization. During its early development, Operation Smile moved from an ad hoc volunteer effort toward a structured international charity. It established a headquarters in Virginia and later created affiliated foundations and programs in countries including Australia, the United Kingdom, Italy, Vietnam, and Ireland. In 1995, it opened its first care center in Duitama, Colombia. The care-center model complemented temporary surgical missions by creating a more continuous setting for assessment, treatment, follow-up, and professional collaboration. In 2007, the organization announced that its headquarters would move from Norfolk to a new facility in Virginia Beach. Its operating model has generally combined donated professional labor, local and international medical partnerships, fundraising, and patient screening. Surgical missions are organized around multidisciplinary teams. In addition to surgeons, teams may include anesthesiologists, pediatricians, intensive-care physicians, coordinating and perioperative nurses, speech specialists, child-development professionals, dentists, and orthodontists. Credential verification and preoperative assessment are central parts of the mission process. Operation Smile has also promoted medical education and local workforce development, reflecting the view that safe surgery requires more than transporting volunteer clinicians to underserved locations. The organization’s work received media exposure through documentaries and public events. A documentary about its activities, The Facemakers: Operation Smile, was produced with BBC One and the Discovery Channel and received recognition in medical and humanitarian documentary competitions. Operation Smile also developed public-facing fundraising and awareness initiatives, including a large multimedia installation in New York in 2007. Support from celebrities and commercial companies helped extend the organization’s visibility beyond the medical sector. Operation Smile experienced a significant period of criticism between 1999 and 2002. Reports involving patient deaths raised questions about medical procedures, organizational practices, and supervision. The charity conducted an internal review and publicly recognized flaws. It communicated proposed changes to its chapters, sought new executive leadership, planned to add a chief medical officer role, and stated that board oversight of volunteer medical personnel would be strengthened. These events remain an important part of the organization’s institutional history because they prompted a more explicit focus on governance and clinical standards. The organization later became involved in a proposed combination with Smile Train, another major cleft-care charity. The merger was announced in early 2011 but was called off only a few weeks later. Afterward, Operation Smile separated the Operation Smile Foundation into Stop Cleft International. Stop Cleft International became a subsidiary of Smile Train in July 2013, and Operation Smile paid an agreed obligation of four million dollars during the 2013 tax year. This episode reflected both the overlapping missions of the two organizations and their distinct approaches to fundraising, surgical delivery, and institutional structure. Financial efficiency and governance also attracted outside attention. Forbes included Operation Smile in its reviews of large United States charities, including a 2011 assessment that placed it among the less efficient large charities by the publication’s selected cost metrics. Such rankings do not independently establish medical effectiveness, but they contributed to public debate over fundraising and administrative spending. The Better Business Bureau Wise Giving Alliance reported that the organization met 19 of 20 standards, with the cited exception involving compensation of board members because two members exceeded the relevant guideline. These issues form part of the charity’s public accountability record, although the organization’s principal service activity has remained free cleft-related surgery and continuing care. By 2022, Operation Smile reported more than 350,000 surgeries in over 60 countries since 1982 and continuing care through 38 smile centers. Its contemporary identity combines direct surgical treatment with training, standards development, long-term follow-up, and efforts to expand access to safe surgery. Partnerships with Hasbro, Sephora, AriZona Iced Tea, Lay’s, and Beast Philanthropy have supported fundraising or education, while public advocates have included entertainment figures such as Roma Downey, Mariah Carey, and Kate Hudson. The organization continues to operate internationally from Virginia Beach.

• 2024

  Beast Philanthropy education partnership

  [1]Operation Smileen.wikipedia.org

  Operation Smile partners with Beast Philanthropy on a video explaining cleft conditions and the organization’s work.

• 2022

  Organization reports global care-center network

  [1]Operation Smileen.wikipedia.org

  Operation Smile reports more than 350,000 surgeries in over 60 countries since founding and continuing care through 38 smile centers.

• 2013

  Operation Smile completes an obligation linked to Stop Cleft International

  [1]Operation Smileen.wikipedia.org

  Stop Cleft International becomes a Smile Train subsidiary, and Operation Smile pays an agreed four-million-dollar obligation during the tax year.

• 2011

  Proposed merger with Smile Train is abandoned

  [1]Operation Smileen.wikipedia.org

  A planned combination with Smile Train is announced and then canceled within several weeks.

• 2007

  Headquarters relocation announced

  [1]Operation Smileen.wikipedia.org

  The organization announces plans to move its headquarters from Norfolk to Virginia Beach.

• 2001

  Operation Smile documentary receives recognition

  [1]Operation Smileen.wikipedia.org

  The documentary The Facemakers: Operation Smile receives recognition in medical and humanitarian documentary competitions.

• 1999

  Medical-practice criticism emerges

  [1]Operation Smileen.wikipedia.org

  Reports concerning patient deaths lead to criticism of the charity’s procedures and organizational oversight.

• 1995

  First care center opens in Colombia

  [1]Operation Smileen.wikipedia.org

  Operation Smile opens its first care center in Duitama, Colombia, extending the organization beyond periodic surgical missions.

• 1982

  Operation Smile is founded

  [1]Operation Smileen.wikipedia.org

  William P. Magee Jr. and Kathleen S. Magee establish the organization after volunteer cleft-care missions in the Philippines revealed substantial unmet need.

International nonprofit medical humanitarian organization combining free reconstructive surgery with medical training, local capacity building, and continuing care for people affected by cleft and related facial conditions.

• Medical humanitarian service · 1982

  Cleft lip and cleft palate surgery

  Operation Smile’s core service is free reconstructive surgery for children and young adults born with cleft lip, cleft palate, and related facial conditions. Patients are screened before treatment, and surgical teams are assembled with specialist medical, nursing, pediatric, anesthesia, and recovery expertise. The procedures are delivered through international missions and local care programs.

• Continuing medical care · 1995

  Smile centers

  Smile centers provide a more continuous care setting than short-term missions. Depending on location and need, services can include assessment, surgery, postoperative monitoring, speech support, dental and orthodontic care, nutrition assistance, psychosocial services, and referrals. The organization reported 38 centers providing ongoing care in 2022.

• Professional education · 1982

  Medical training and capacity building

  Operation Smile trains and works with local clinicians and hospitals to improve the availability and safety of cleft-related care. Its programs address clinical skills, team coordination, standards, and institutional capacity so that treatment can increasingly be delivered through local systems rather than relying exclusively on visiting teams.

• 2011

  Aborted merger with Smile Train

  The proposed merger with Smile Train was announced and then canceled within weeks, creating a significant governance and strategic episode in the history of both charities.

  Source

• 1999

  Criticism following patient deaths

  Specific patient deaths led to scrutiny of Operation Smile’s medical procedures and organizational practices. The organization conducted an internal review and publicly acknowledged shortcomings.

  Source

Read more

• 2024Beast Philanthropy cleft-care education video

  Global digital audience

  Operation Smile worked with MrBeast’s Beast Philanthropy on a YouTube video explaining cleft lip and palate and describing the organization’s work.

  Outcome. Digital education and awareness

  Source
• 2018Lay’s partnership

  United States

  Operation Smile partnered with Lay’s potato chips in a consumer-facing fundraising and awareness effort.

  Outcome. Corporate fundraising partnership

  Source
• 2007New York multimedia awareness project

  United States

  A multimedia project featuring a seven-story sphere at South Street Seaport presented Operation Smile’s humanitarian mission to a broad public audience.

  Outcome. Public education and awareness

  Source
• 2006The Smile Collection

  United States

  A New York fundraising event connected with Operation Smile received volunteer support from singer Mariah Carey.

  Outcome. Fundraising and public awareness

  Source
• 2002Mr. Potato Head fundraising initiative

  United States

  Operation Smile was featured in a Mr. Potato Head contest, with proceeds supporting the charity. Hasbro also donated toys for Operation Smile missions.

  Outcome. Fundraising and in-kind support partnership

  Source

• 2011

  Pursue and then abandon Smile Train mergerM&A

  Background

  Operation Smile and Smile Train shared a focus on cleft care but operated with different organizational histories and approaches.

  Action taken

  The charities announced a merger and withdrew from the plan approximately three weeks later.

  Aftermath

  Operation Smile later separated its foundation into Stop Cleft International, which became a Smile Train subsidiary in 2013.

  Agreed obligation paid to Stop Cleft International/Smile Train. 4000000 USD (2013 tax year)

  • Smile Train — Smile Train became the later parent of Stop Cleft International after the proposed merger was abandoned.

  Source

• 2007

  Move headquarters to Virginia BeachStrategy

  Background

  The organization had been headquartered in Norfolk, Virginia.

  Action taken

  Operation Smile announced relocation to a new building in Virginia Beach.

  Aftermath

  Virginia Beach became the organization’s reported headquarters.

  Source

• 2000

  Strengthen clinical and board oversightStrategy

  Background

  An internal review followed criticism related to patient deaths and concerns about medical procedures.

  Action taken

  Operation Smile said it would seek new executive leadership, add a chief medical officer position, and strengthen board supervision of volunteer medical staff.

  Aftermath

  The reforms became part of the organization’s response to scrutiny of its clinical and governance practices.

  Source

• 2024

  Operation Smile collaborates with Beast Philanthropy[1]Operation Smileen.wikipedia.org

  Campaign

  Operation Smile partnered with MrBeast’s Beast Philanthropy on a video intended to explain cleft conditions and the organization’s medical work.

• 2018

  Operation Smile partners with Lay’s[1]Operation Smileen.wikipedia.org

  Campaign

  The organization entered a fundraising and awareness partnership with Lay’s potato chips.

• 2011

  Operation Smile and Smile Train announce a proposed merger[1]Operation Smileen.wikipedia.org

  M&A

  The two cleft-care charities announced plans to combine, but the transaction was abandoned roughly three weeks later.

1. 1Operation Smileen.wikipedia.org
2. 2Operation Smile official websiteoperationsmile.org