In her infancy, 16-year-old Laura had an operation to correct her cleft palate. Now, she has a misshapen face. To test whether early surgery was the cause of such growth problems, Michael Mars of Great Ormond Street Children's Hospital visited Sri Lanka in 1984 to examine untreated adults. He discovered that, although they had normal growth, they suffered almost unintelligible speech. The nature and timing of the surgery need to be established to minimise both these problems, and Mars has since returned to Sri Lanka with a surgical team of volunteers to search for a compromise.