In addition to providing cleft lip and palate repair surgeries to children worldwide, Operation Smile works as a non-governmental organization to reduce the occurrence of cleft lips and palates worldwide; develops ambassadorships to raise awareness of cleft issues; sponsors a World Care Program to attend to international cases demanding the highest level of care; organizes chapters and foundations worldwide to assist countries in reaching self-sufficiency with cleft surgeries; hosts the U.S. Care Network to assist families in the U.S. with cleft issues; develops and administers worldwide education programs related to cleft issues; and organizes student programs worldwide to develop leadership, commitment, and volunteerism values in young people.
As of March, 2013, Operation Smile had provided according to its own accounting more than 3.5 million comprehensive patient evaluations and over 200,000 free surgeries for children and young adults born with facial deformities.
Operation Smile was created by Dr. Bill and Kathy Magee after they participated in a Philippine cleft repair mission in 1982 and recognized a need for more missions.
According to a 2003 interview, when asked about the start of Operation Smile, Magee said:
It was guilt. We were invited to join a group going on a medical mission to the Philippines. We saw hundreds of children and saw many more turned away.
The scope of the organization increased after Mother Teresa invited Operation Smile to come to India to treat deformed children.
Bill Magee (Dr. William P. Magee Jr., D.D.S., M.D.)
Kathy Magee (Kathleen S. Magee, B.S.N., M.Ed., M.S.W.)
Dr. Magee is the Executive Chairman of Operation Smile and a faculty member of both the Children's Hospital of the King's Daughters and Eastern Virginia Medical School. His wife, Kathy Magee, serves as the president on a full-time, volunteer basis and is a lifetime member of the Board of Directors.
Dr. William P. Magee, Jr. and Kathleen S. Magee were awarded The Spirit of Raoul Wallenberg Award from the American Swedish Historical Museum in 1998 for their work in establishing a network of professionals and volunteers engaged in restoring badly deformed faces of children. Later, in 1999, Kathleen Magee was awarded with the World of Children Award for her contributions to helping vulnerable children through her efforts with Operation Smile. Dr. Magee received the 2001 Antonio Feltrinelli Prize (Premi "Antonio Feltrinelli" awarded by the Accademia Nazionale dei Lincei for Exceptional Endeavors of Outstanding Moral and Humanitarian Value, received the U.N. Servants of Peace Award, presented the Honorary Kazanjian Lecture to the American Society of Plastic and Reconstructive Surgeons, and in 1998, received the Distinguished Service Award from the American Society of Plastic Surgeons.
Operation Smile organizes international volunteer missions to provide cleft lip and palate repair in developing countries, coordinates programs for training physicians from around the world, manages programs to assist host countries in reaching cleft lip and cleft palate repair self-sufficiency, supports education and research programs to eradicate cleft lips and palates, and organizes global volunteer programs for high-school and college students.
Teams are organized with volunteers from within the host nation as well as from other nations. Many of the volunteers provide important logistical (non-medical) support to the mission; they may serve as translators, medical records technicians, photographers, or help in such areas as food services, lodging, procurement of supplies, or transportation. The teams also typically include two high school students who fulfill various functions, including giving presentations on health maintenance and dental hygiene to families living near the mission site. Operation Smile coordinates the donation, purchase and delivery of medical provisions (equipment, medications, supplies) for each mission.
In 2005, these volunteer medical teams provided free surgeries for 8,359 children through international and local, in-country medical missions. During the fiscal year of 2009, Operation Smile provided free surgeries for nearly 13,000 children and young adults suffering from cleft lip and/or cleft palate.
Iraq - In 2007 the health minister of Iraq's Kurdistan region, Dr. Zorban Othman, announced that Operation Smile would treat 51 Kurdish children in nearby Jordan. The Dr. stated "the step was taken because of the bad security conditions in other areas of Iraq, which makes it impossible for foreign physicians to come."
On a case by case basis, Operation Smile will bring extraordinary craniofacial cases to Norfolk, Virginia—when mission conditions are inappropriate for the severity of the case. As of June 2007, approximately 200 World Care patients have been treated. The program may be expanded to other locations.
Chapters & foundations
Operation Smile has Global Resource Chapters that raise funds and awareness to support its programs. Mission teams are hosted by International Foundations that are responsible for all in-country mission logistics and that also raise funds and awareness throughout the year.
Comprehensive Care Clinics To aid countries in becoming self-sufficient at caring for cleft patients, beginning in early 2007 the organization will open seven medical clinics in Colombia, Honduras, Morocco, China, India, the Philippines and Vietnam. The centers will provide surgeries and treatment, educate local volunteers, perform local development activities and manage local communications / administrative services. The center in Vietnam will treat 2,000 patients annually and train about 1,000 medical professionals.
U.S. Care network
Operation Smile provides a network of resources to assist families in the U.S. with children born with facial deformities. This network is accessed through the Operation Smile Web site and includes a listing of Referral Web Sites plus a Physicians Resource List with the names of doctors available to review a case.
Operation Smile provides a framework for its partner countries to come together to share knowledge, technology and skills through the use of programs customized to each country’s specific medical infrastructure. University Partnerships offer Operation Smile medical volunteers training in advanced techniques and provide opportunities including fellowships, emeritus professorships and visiting professorship programs. Education Exchange programs are also offered through partnerships with leading medical teaching institutions.
The annual Operation Smile Physicians' Training Program (PTP) brings surgeons from around the world to the United States for training in specialized surgical skills. The program has helped train more than 650 international physicians in advanced craniofacial techniques.
Operation Smile has twice hosted a global summit on medical standards in Norfolk, VA.
More than 600 Operation Smile Student Associations in the United States and around the world build awareness, raise funds and educate students about the values of commitment, leadership and volunteerism.
Operation Smile sends hundreds of students on missions each year. Generally two go on each mission, along with an adult sponsor. The student team takes toys and games to help keep the kids occupied while waiting for surgery. Before the students go on a mission however, they must apply and be selected to attend Mission Training Workshop (MTW), which is held twice a year. At MTW students are taught four health modules, Dental Hygiene, Oral Re-hydration Therapy, Nutrition, and Burn Care and Prevention. Students make posters for each of these modules and present them on the missions, delivering critical information teaching families simple things that can save lives.
The International Student Leadership Conference (ISLC) is a big aspect of Operation Smile Student Programs. The 2006 ISLC was held at Weber State University in Utah, and the 2005 ISLC was held at William & Mary in Virginia. The 2007 ISLC was held at the University of Limerick in Ireland. The 2008 ISLC was held at San Diego State University, the 2009 ISLC was held at Christopher Newport University in Virginia, and the 2010 was held at the University of Denver.
Awards and milestones
In 2001 a documentary on the work by Operation Smile won the US Circle of Excellence Media Awards for Best Medical Documentary and it was the finalist in the New York Film Festival Awards for Best Humanitarian Documentary. The documentary titled The Facemakers: Operation Smile is a co-production by British television] BBC 1 and American Cable the Discovery Channel in conjunction with Century Films and it documents the remarkable changes that occurred in the lives of three children as a result of Operation Smile's visit to Davao City in the Philippines in 1999. The fifty minute programme was first aired on 21 June 2001. Two of the children received surgery during the mission. Nine-year-old Rozal Garces was treated for her cleft lip, and four-year-old Amorjoy Felipe had a cleft lip and palate revision. The third child, Abel Gastardo, had a condition too severe to be treated during the time of the mission. Abel suffered from a nasofrontal facial encephalocele, an extreme protrusion of brain tissue from the front of his skull. The film follows Abel to the United States to receive corrective surgery, seven months later. He was brought over by Operation Smile to receive major surgery in Virginia, at the Children's Hospital of The King's Daughters.
To mark its 25th anniversary in November 2007, Operation Smile undertook the World Journey of Smiles (WJOS), a single campaign that included 40 simultaneous missions over a period of two weeks in 25 countries—beginning with the return to the site of Operations Smile's first mission. During WJOS, Operation Smile completed 4,200 cleft lip/palate surgeries with 1,700 volunteers from 43 countries. The World Journey of Smiles also collected DNA samples from 4,200 children—the largest sampling ever made and now housed at Yale University. The previous largest sampling included the DNA of 200 children.
Bill and Kathy Magee were honored on March 1, 2008 with the Norfolk First Citizen Distinguished Service Award.
Criticism and response 1999-2002
In November 1999, specific patient deaths brought criticism on Operation Smile's medical procedures, suggesting the organization prioritized publicity and volume over patient welfare and safety. In response, Operation Smile conducted an internal review. Initially, the organization "promised to make public the full findings of the review", though later chose not to release the findings, considering the review "an internal matter". Several directors disagreed with this choice and left the board. Four months after announcing the review, the organization publicly admitted organizational flaws. By 2002, the organization also established medical credential standards, improved medical monitoring of patients, and implemented quality and financial controls.
Operation Smile and Smile Train
In early 2011, Smile Train and Operation Smile announced the two charities would merge, followed three weeks later by announcements the merger had been aborted, Smile Train having canceled the union. Smile Train's board also named Priscilla Ma the executive director of the organization, while other board members and directors stepped down.
In 2009, Smile Train initiated an advertising campaign  in the Richmond Times highlighting Smile Train's attempts between 2006 and 2009 to donate nearly $9 million to Operation Smile, the organization Brian Mullaney had split from in 1998 in what Mullaney described as a "messy divorce."
In the ad, Mullaney contended Operation Smile was refusing money that could benefit children, later calling the situation "shameful"; Mullaney also noted that he respects that in some countries need overwhelms available doctors and he had "a newfound respect for what Operation Smile does." The Virginian Pilot outlined the history and differences between the two organizations and indicated Mullaney wanted the two organizations to reconcile.
At the time, Dr. Magee of Operation Smile declined a newspaper interview, and Operation Smile formally responded to the ad campaign, saying the two organizations "have different operating philosophies and business ethics," and that Operation Smile would continue foregoing donations from an "unproductive relationship."
Operation Smile's 2013 Financial Overview report shows an income of $49,516,821 in cash contributions. The report indicates an expenditure of $23,189,296 for fundraising and administration. Financial reporting for the fiscal year ending June 2014 are not yet available. 
In 2011, Forbes ranked Operation Smile as the tenth "least efficient" large U.S. charity, tied with the Alzheimer's Association and just ahead in efficiency of the American Cancer Society. Forbes noted that "financial efficiency is far from the whole story when it comes to assessing a charity’s vitality or even effectiveness."
Operation Smile spends 42% of the money donated to the charity on fundraising and administration, including a salary of over $331,000 for its chief executive.
The NGO raised $35,024,864 during the fiscal year ending June 2008. They spent 41% of the cash revenues on fundraising and administration; $11,905,507 on fundraising (33.9%) and a further $2,710,783 on management (7.7%).
Operation Smile also operates the Operation Smile Foundation, a separate registered non-profit whose sole purpose is to raise funds for Operation Smile. The Foundation spent $7,267,834 on fundraising and raised $8,387,513 in the tax year ending June 30, 2007. The Foundation transferred a total of $781,858 to Operation Smile. http://operationsmile.org/docs/990_2006_osf.pdf
Operation Smile does not meet two of the twenty standards for charities established by the Better Business Bureau Wise Giving Alliance.
Operation Smile in popular culture
A 2007 multimedia project featured a seven-story sphere at South Street Seaport in New York, NY. Microsoft worked with Operation Smile, Digital Kitchen (a design firm) and the Wexley School for Girls (Seattle, WA) to have photographic images of visitors projected onto the sphere. (See also: Case Study)
A 2005 movie, Smile, directed by Jeffrey Kramer was loosely based on the experiences of a student Operation Smile volunteer.
An ongoing co-branding campaign between Operation Smile and Sephora combines the NGO's name with the companies products, raising over $400,000 for the NGO. The Operation Smile Sephora Lip Baume was listed at number five on Lara Spencer's "Lara's Hot Shopping List, Hot Products for Women".
An ongoing co-branding campaign between Operation Smile and AriZona Iced Tea features the tea company's three best selling (one liter) products' labels replaced with Operation Smile branded messaging, mission statement and photos of children with cleft repairs.
Film producer, director, producer, and author Perry Moore (The Chronicles of Narnia, Executive Producer; author of the LAMBDA award-winning HERO) was a student volunteer in 1988 and, trained as a scrub and health care advisor, he was part of the team that traveled to Manila and then to Naga City in the Philippines.
Operation Smile announced in late 2007 that it would relocate its world headquarters approximately 16 miles (26 km) from its current location in Norfolk, to a new building in Virginia Beach. The projected 65,000-square-foot (6,000 m2) building is sited adjacent to a projected regional health profession center to be built by Tidewater Community College. The headquarters will occupy land owned by the city of Virginia Beach and will receive funds from the city for site improvements, including landscaping, utility service and sidewalks.
As of May 2014, the Operation Smile website lists the new address at 3641 Faculty Boulevard, Virginia Beach as its headquarters.