The ultimate goal in cleft surgery is to find a balance between aesthetic, functional, and growth concerns. The cleft surgeon must have a profound understanding of the surgical and functional anatomy of the cleft. Each step of the treatment has its effect on the next one. It is like a puzzle and there is only one right way to put the pieces together. .The author believes in a multistep approach to the cleft treatment, “one miracle at the time!” Our fundamental philosophy is to do as little as possible and wait for the healing forces of nature before doing the next step. In fact each step is a preparation for the next one. Again like putting back a puzzle together.