The departmental goal was for Dr. Chase, in collaboration with Dr. John Kirchner of otolaryngology and Dr. Donald Shedd of general surgery, to develop plastic surgery as a support mechanism for a center in head and neck surgery.
During the academic year 1968-69, the Department of Surgery continued to grow in strength, thriving in the areas of teaching, research and service commitments. Dr. Thomas Krizek, an outstanding young recruit who went on to become the Associate Dean for Graduate and Continuing Medical Education and an appointed member of the Board of Directors of the American Board of Plastic Surgery, established a formal Plastic and Reconstructive Surgery Section within the Department of Surgery. Additionally, under Dr. Krizek’s direction, the Residency Training Program in Plastic and Reconstructive Surgery was approved.
New Recruits, New Advances in Medicine
In the 1970’s, the department continued to build the Section of Plastic Surgery with the recruitment of new faculty including Drs. Martin Robson and William Frazier. The section experienced diverse growth in the areas of teaching, research and scholarship through the combined efforts of the full and part time faculties. This time also brought about clinical advancement with a major contribution to wound healing management. The Department of Plastic Surgery was on the forefront of objectively qualifying the number of bacteria in wounds required for infection to occur, incorporating this information into patient management of wound debridement, closure and skin grafting.
In 1976, new and promising surgeons were appointed new roles.
- Dr. Stephen Ariyan was appointed Assistant Professor of Surgery after completing his residency at Yale with a major interest in immunobiology of head and neck cancers.
- Dr. Irving Polayes, associate Chief of the section, was promoted to Clinical Professor of Plastic Surgery.
- Dr. Neal Koss was elected President-Elect of the Society for Computer Medicine.
- Dr. Marvin Arons became Chief of the Section of Plastic and Reconstructive Surgery at the Hospital of St. Raphael and for the first time residents rotated through the program.
- Dr. Stephen Flagg continued to be active on the hand service and was elected President of the Southern New England Hand Society.
- Dr. Polayes was elected Vice President in both the American Society of Maxillofacial surgeons and the New England Society of Plastic and Reconstructive Surgeons.
Profound Change Continued at Yale Through the Decades
1978 marked the end of a period of profound change with Dr. Krizek accepted the position as Professor and Chief of Plastic Surgery at Columbia University in New York. Additional changes during the late 1970’s within the section included:
- Appointment of Dr. William Frazier as Interim Chief until the appointment of Dr. Stephen Ariyan in 1979.
- Drs. Mary Mcgrath and Charles Cuono joined the section.
- Extensive education expansion to include programs to address congenital deformities, hand surgery, maxillofacial and other trauma, head and neck cancer and aesthetic surgeries and burn patients.
- Establishment of a Microsurgery Service to coordinate and concentrate expertise in replantation, microvascular and free-flap surgical techniques.
- Appointment of Dr. Mark Weinstein as Clinical Instructor in Surgery after completion of his training at UCLA and rapidly became a valuable contributor to theYale-New Haven Medical Center.
- Development of a national course in maxillofacial surgery led by Dr. Polayes.
- Establishment of a human cadaver skin bank for use in grafting procedures under the guidance of Dr. Charles Cuono.
- Continued research efforts in the areas of surgical infection, tumor immunology, wound healing, microsurgery, glycoproteins and seromucoids and flap physiology.
The 1980’s were a pivotal time for the Section of Plastic Surgery. In 1983, the faculty expanded with the recruitment of Drs. Zeno Chicarelli and Richard Stahl. In 1985, Dr. Ariyan was appointed the prestigious honor of President of the New England Society of Plastic and Reconstructive Surgeons in 1986. His accomplishments continued as an editorial board member for plastic and Reconstructive Surgery and a board member of the American Board of Plastic Surgery. It was also during this time that he authored the authoritative textbook, Cancer of the Head and Neck, and also received the Distinguished Service Award from the Society of Head and Neck Surgeons in May 1989.
- Dr. John Persing, was recruited from the University of Virginia to become the new Section Chief. Dr. Persing, since coming to Yale in 1992, has overseen the initiation of the integrated six-year residency in Plastic Surgery, initiated the craniofacial center and with colleagues the development of fellow-ships in hand surgery, microvascular breast surgery, and craniofacial surgery. He has also held leadership posts in multiple plastic surgery organizations from being a Director of the American Board of Plastic Surgeons, to ultimately becoming the Chair of the Board of Plastic Surgery in 2006. He has also been President of the American Association of Plastic Surgeons, the Association of Academic Chairman of Plastic Surgery, the American Society of Maxillofacial Surgeons, the Plastic Surgery Foundation, the American Association of Pediatric Plastic Surgeons. He is Chair of the Board of Trustees, as well as a member of the Board of Directors of the American Society of Plastic Surgery, among other posts.
- Harry Spinelli, MD was appointed Assistant Professor and along with Dr. Cuono maintained academic motivation and growth
- Research efforts continued in the areas of immunobiology and molecular biology of the skin, real time assessment of skin grafts and flaps, development of permanent skin replacement and wound healing and infection.
- The Plastic Surgery Research Laboratory continued to investigate the effects of biologic dressings in open wounds, particularly burns utilizing cryopreservation of freeze dried material that could be reconstituted and applied to burn wounds.
- A human cadaver skin bank was established and basic research in the viability and efficacy of this type of wound coverage occurred
- The Melanoma Immunology Laboratory continued to evaluate the efficacy of intralymphatic immunotherapy by monitoring the cellular immune mechanisms in patients by lymphocyte cytotoxic assays
- Medical students and students from the Department of Epidemiology and Public Health completed their doctoral or masters theses in health quality assurance in areas of wound bacteriology, surgical infections, wound healing and skin allograft biology.
- A joint project between the Sections of Plastic Surgery and Cardiothoracic Surgery was initiated to investigate the feasibility of reconstructing skeletal muscle ventricles for cardiac assistance or cardiac replacement.
- Dr. J. Grant Thomson initiated a hand program which continues to bring expertise and skill to reimplantation and microvascular reconstruction to this day. He additionally coordinated the Upper Extremity Program for the treatment of mangled extremities, initiated first hand fellowship approved by the ACGME at Yale and presently remains the program director for the hand fellowship. His accomplishments continued as he was elected President of the New England Plastic Surgery Society and the New England Hand Society and is the originator of the overseas volunteer program “Hand Help”, which has been annually visiting Latin America providing otherwise unavailable care to those with extremity injuries.
- Dr. Richard Restifo, was recruited to direct the University Plastic Surgery Breast Program to coordinate medical and surgical oncologists to deliver reconstructive options to patients with breast cancer. Although he has since started a private practice, the program continues full force under the direction and guidance of a team of physicians including Drs. Alex Au, Michael Alperovich, Tomer Avraham, Stefano Fusi, Jeffery Solomon and Stirling Craig.
Our Research and Faculty Expansion Continues to Thrive
Starting in the 2000’s and continuing until today, research efforts continued to thrive with the appointment of several new faculty members and the continuation and initiation of research initiatives including:
- Dr. Thomas L. McCarthy joined Dr. Michael Centrella to continue their NIH sponsored research which was an integral to the understanding of bone development and possible perturbations with disease and congenital deformities. Their research focused on the interactions of osteoblasts and cytokines to enhance and maintain bone structure during development.
- Dr. David Leffell, an internationally renowned skin cancer expert, was appointed as Affiliated Faculty from the Section of Dermatology.
- Dr. Joseph Shin (now Chief of Plastic Surgery at Dartmouth), was appointed Director of the craniofacial team following a craniofacial fellowship at the University of Miami to enhance the treatment of congenital facial deformities, such as clefts of the face. During this time, novel instruments and operative techniques were developed in distraction osteogenesis of the facial skeleton. The craniofacial program continued to grow and expand. Dr. Derek Steinbacher, was named Director of the Craniofacial Program. His combined degrees in dentistry and medicine have afforded him the opportunity to expand Yale’s Craniofacial Program as the Chair of Dentistry at YNHH and Supervisor of the Maxillofacial Residency Program within the medical center. Dr Steinbacher is also the Director of the Yale Craniofacial Fellowship, with our first fellow Dr. Raj Sawr Martinez appointed in 2017.
- Dr. Michael Alperovich was recruited to Yale from NYU following his residency in plastic surgery and a fellowship in craniofacial surgery. He has been supporting the microvascular breast reconstruction effort with colleagues over his first year, and will now be focusing his efforts toward craniofacial surgery. He has developed a substantial ongoing research effort related to pathology and neurocognitive outcomes in craniofacial surgery and breast reconstruction.
- Former Yale resident, Dr. Deepak Narayan, now Professor of Plastic Surgery and Chief of Plastic Surgery at the VA (West Haven), has focused his work on mechanisms of pathology and surgical treatment of melanoma and its reconstruction, identifying novel methods of treatment for some of the most complex of problems to include using biophage treatment for resistant bacterial infections. He currently serves as President of the New England Plastic and Reconstructive Surgery Society.
- Dr. Henry Hsia returned to Yale following a plastic surgery residency and NIH sponsored post-doctoral research fellowship at Princeton to serve as Director of the Yale New Haven Hospital Wound Center. He and his team plan to implement a system wide, coordinated approach among practitioners to enhance care of problematic, chronic wounds. His current research efforts focus on nanotechnology delivery of treatment products, and clinical responsibilities to help patients with these very difficult physiologic and psychosocial impacts.
- Dr. Jim Clune, has also returned to Yale following residency and an orthopedic based hand/upper extremity fellowship at UC Irvine. He has received specialized training in complex hand surgery, specifically wrist and carpal bone fractures, and peripheral nerve surgery to include segmental nerve transfers for brachial plexus reconstruction. He has interests in oncologic reconstruction and collaborates with the orthopedic faculty and Dr. Thomson in this work.
Plastic Surgery Residency Then and Now
Through combined faculty efforts, including strong support of Dr. Zeno Chicarelli, the Chief of Plastic Surgery at St Raphael’s campus and Dr. Mark Weinstein, organizer of multiple site overseas volunteer surgery programs, the clinical and research aspects of plastic and reconstructive surgery continued. The plastic surgery residency evolved from a traditional plastic surgery residency following a general surgery residency to a six-year integrated plastic surgery program. Through the combined efforts of the Section of Plastic Surgery and the Department of Surgery, Yale’s Section of Plastic Surgery residency program remains one of the very best in the nation. Offering breadth, volume and emphasis on improvement and innovation, graduates of the program are amongst the top plastic surgeons worldwide.