Velopharyngeal (VPI) Surgery

Conveniently located to serve New York City, Manhattan, Long Island, & New Jersey.


VPI, or velopharyngeal incompetency, consists of air escape through the nose and therefore, normal speech sounds cannot be made. VPI is first treated by a speech therapist at the time of speech development. If VPI is still present after the speech therapy, a surgical procedure may be warranted. A screening test (nasoendoscopy) may be needed and Dr. Gargano will tailor your procedure based on the test results.

VPI Surgery Objectives

  • To close the space at the back of the throat and avoid air escape through the nose. 
  • To gain a normal speech development.
  • To avoid breathing problems such as obstructive sleep apnea.

State of the art VPI Techniques

Dr. Gargano evaluates VPI with a speech therapist and then will perform a nasoendoscopy. Depending on the anatomical defect, he will perform either a pharyngoplasty (sphincter tightening) procedure or pharyngeal flap procedure. These procedures allow for proper closure when necessary during speech, but still allow for adequate nasal airflow.

During a pharyngoplasty, tissue behind the tonsils is lifted and connected across the back of the throat to the soft palate. For a pharyngeal flap procedure, a flap of tissue in the back of the throat is lifted and attached to the soft palate. These procedures require use of anesthesia and creation of very small and precise incisions.


Patients with persisting VPI issues who have not been able to resolve them using non-surgical methods would be the ideal candidates for Velopharyngeal (VPI) Surgery.

Other than the VPI, the health of the patient should be sound, with no critical medical issues that are currently being treated. Patients who are still in recovery following a recent surgical procedure may need to wait until they are fully recovered to undergo a corrective procedure.

Is VPI surgery always necessary?

No. Generally, speech is corrected with palate surgery. It is only necessary to perform corrective VPI surgery if air escape is present.


How do I know which procedure to have?

It will depend on the anatomic problem. Speech assessment and nasoendoscopy will determine which surgery is indicated.



Schedule your consultation for Velopharyngeal (VPI) Surgery in NYC to learn more about the procedure. We will be happy to help you restore proper speech.


To ensure a safe and effective Velopharyngeal (VPI) Surgery procedure, patients will need to schedule a consultation.

During this consultation, the details of both procedure options will be explained so that patients can prepare properly for surgery and for the recovery period. Patients can ask questions regarding their procedure options. Patients must also answer questions about their complete medical history.

Meet Dr. Gargano

Plastic & Reconstructive Surgeon, New York

Dr. Francesco Gargano has extensively trained around the world and is committed to healing through individualized care. He is certified by the American Board of Plastic Surgery and the European Board of Plastic Reconstructive and Aesthetic Surgery. He is also a member of the American Society of Plastic Surgeons (ASPS). Dr. Gargano received his medical degree from the Sapienza University of Rome in Italy, graduating magna cum laude. He continued his education at Sapienza University where he earned his PhD in Plastic Surgery, Human Anatomy and Dermatology, and completed his first residency in Plastic & Reconstructive Surgery.


Dr Gargano with the team

Before & After’s

Before & After PhotoBefore & After Photo
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