Major components of the face develop between 4 and 7 weeks in utero. There are three mesodermal islands, one central and two lateral. Prepalatal clefts are caused by failure of these mesodermal elements to develop and fuse. Palatal clefts are caused when the palatal ridges fail to migrate medially, contact, and fuse (Figure 42.1).

References

• Ganske IM, Rogers-Vizena CR. Cleft lip and palate: principles and treatment. In: Chung KC, ed. Grabb and Smith's Plastic Surgery. 9th ed. Wolters Kluwer; 2025:183-196.
• Schafer S, Card E, Liao EC. Cleft lip and palate: embryology and genetics. In: Chung KC, ed. Grabb and Smith's Plastic Surgery. 9th ed. Wolters Kluwer; 2025:197-208.