Operation Smile, a world reference organisation in cleft lip and palate surgery, has featured Dr. Nico Sierra as a second-generation volunteer in an article published on its own website. The article highlights his career as a specialist cleft lip and palate surgeon and his current role training the next generation of surgeons within the organisation.

Why Operation Smile exists and its role in cleft lip and palate care

Cleft lip and palate is one of the most common congenital conditions, present in roughly 1 in every 700 births worldwide. In many countries, access to good-quality reconstructive surgery remains limited, which leaves a considerable number of children and adults untreated, or with incomplete treatment, for years.

Operation Smile works in precisely that gap: it organises surgical missions and training programmes on several continents to widen access to cleft lip and palate surgery and to improve the quality of care in regions with limited resources. Its model is not limited to operating; it includes training local surgeons and teams so that surgical capacity stays in the country long after each mission ends. It is within this training model that the article places Dr. Nico Sierra.

International recognition of Dr. Nico Sierra’s career

The Operation Smile article traces Dr. Nico Sierra’s path from his initial training to his current role as a trainer of other surgeons on international surgical missions. Operation Smile sums up that transition in a phrase the article itself highlights: expertise becomes more valuable when it is passed on.

This kind of recognition, published directly by the organisation and not by an outside outlet, carries particular weight: it confirms first-hand a career that Dr. Sierra already shared with his patients, now backed by the institution he has worked with since 2015 as a volunteer, educator and field medical director.

A family story: two generations at Operation Smile

What sets this recognition apart is its family dimension. Dr. Nico Sierra’s father, Dr. Plinio Sierra, a paediatric anaesthetist, has volunteered with Operation Smile for more than 30 years and currently serves as the organisation’s regional medical director for the Middle East and North Africa.

Dr. Nico Sierra continues that family commitment, but through reconstructive cleft lip and palate surgery. Operation Smile describes this continuity as a generational handover: two doctors from the same family, in complementary specialities — paediatric anaesthesia and maxillofacial surgery — dedicated for decades to the same cause on surgical missions across several continents.

From student to trainer: Dr. Nico Sierra’s international training

The career that Operation Smile highlights cannot be understood without the specific training behind it. Dr. Nico Sierra completed his residency in Barcelona and a fellowship in Craniofacial Surgery and Cleft Lip and Palate at the Federal University of Paraná (UFPR), Curitiba, Brazil, an international reference centre in this field.

To this he added a period at the Guwahati Comprehensive Cleft Care Center in India, one of the highest-volume centres for cleft lip and palate surgery in the world. This training in Asia adds to his surgical missions with Operation Smile in Africa and Latin America, completing a training path across four continents that now allows him to act not only as a surgeon, but as a trainer of other specialists.

The same teaching vocation is visible in Barcelona: as a member of the Paediatric Maxillofacial Surgery Unit at Vall d’Hebron University Hospital, Dr. Nico Sierra takes part in training resident doctors and specialists in cleft lip and palate surgery, contributing to the development of the next generation of surgeons both inside and outside the hospital setting.

Why this recognition matters for patients

For a family looking for a cleft lip and palate surgeon, this kind of recognition offers something that is not always easy to assess from the outside: external, independent confirmation of the clinical experience and teaching commitment of the person who will operate on their child.

Exposure to a high and very varied volume of complex cleft lip and palate cases — in Barcelona, at Vall d’Hebron University Hospital, and on international surgical missions with Operation Smile on several continents — is precisely what distinguishes a surgeon with a specific dedication to this field. Available studies show that patients treated by surgeons with a high caseload and a specific dedication to cleft lip and palate often achieve better functional and aesthetic results.

This Operation Smile recognition does not change Dr. Nico Sierra’s clinical approach or the way he cares for his patients in Barcelona. What it does is highlight, from an outside institution, a career that was already part of his daily practice: that of a surgeon who keeps learning, keeps operating in demanding settings, and now also trains those who come after him.

What to look for when choosing a cleft lip and palate surgeon

Recognition such as Operation Smile’s is useful because it offers an objective criterion for families choosing a surgeon: specific training in cleft lip and palate, the number of cases treated, and validation by institutions outside the professional’s own practice.

In Dr. Nico Sierra’s case, that validation rests on several verifiable elements: his fellowship at UFPR (Brazil), his academic work with publications indexed in PubMed in collaboration with the Children’s Hospital of Philadelphia, his link with Vall d’Hebron University Hospital, and now also this Operation Smile article on his role as an international trainer. None of these elements replaces an individual clinical assessment, but they do help a family understand the kind of experience their surgeon has before the first consultation.

Consultation in Barcelona with an internationally trained surgeon

Dr. Nico Sierra sees patients for consultation and personalised assessment at Clínica Tresserra. For families who live outside Barcelona — elsewhere in Spain or in other countries — the team offers an initial assessment by telemedicine and remote review of studies and images. The length of stay and the follow-up depend on each case.

This combination of international experience and availability for patients from outside Barcelona is consistent with the profile Operation Smile describes: a surgeon trained and active on several continents, who applies the same clinical judgement on humanitarian missions and in daily practice at Clínica Tresserra.

In summary

Operation Smile has featured Dr. Nico Sierra as a second-generation volunteer, highlighting his international training — Barcelona, UFPR Brazil and the Guwahati Comprehensive Cleft Care Center in India — and his current role training future cleft lip and palate surgeons, both at Vall d’Hebron University Hospital and on international surgical missions. It is a recognition that confirms, from the outside, a commitment that Dr. Sierra and his family have kept for more than three decades.