History

Over the past 100 years, Washington University School of Medicine faculty have played a leading role in the development of the plastic surgery specialty and of new training concepts and ideals for plastic surgeons in the United States.

Plastic surgery as a specialty evolved during the 20th Century in this country. One of the founders of the specialty – Dr. Vilray Blair – served as the first chief of the Division of Plastic and Reconstructive Surgery at the medical school.

In one of his many areas of clinical expertise, Blair treated World War I soldiers with complex maxillofacial injuries, and his paper on “Reconstructive Surgery of the Face” set the standard for craniofacial reconstruction. He was also one of the first non-oral surgeons elected to the American Association of Oral and Plastic Surgery (later renamed the American Association of Plastic Surgeons) and taught many surgeons who became leaders in the field of plastic surgery.

One of Blair's brightest pupils was Dr. James Barrett Brown, who succeeded Blair as chief of the Division in 1946. Brown's contributions were initially linked with those of Blair. In the 1920s, they introduced the revolutionary concept of using large skin grafts for the treatment of severe burns and described how to make the grafts work. Later, Brown assembled a large team of plastic surgeons to treat wounded veterans returning from World War II, which led to the development of new techniques and strengthened the role of plastic surgeons in hand reconstruction.

Plastic surgeons who trained under Blair and Brown went on to introduce many innovations in plastic surgery including:

• The development of a dermatome (instrument for cutting thin skin slices for skin grafts) that allowed surgeons to consistently harvest large sheets of split-thickness skin for grafting
• Development of a detailed analysis of facial growth used in craniofacial surgery
• Improved treatment in cleft lip repair

From 1968-1970, Dr. John E. “Jack” Hoopes served as chief of the Division of Plastic and Reconstructive Surgery. After Hoopes went on to distinguished service as chairman of Plastic Surgery at Johns Hopkins University School of Medicine, Dr. Paul M. Weeks began his tenure as division chief. In addition to his personal achievements as a leader in hand trauma and tendon repair, Weeks did much to promote plastic surgery residency training at Washington University and nationwide. He laid the groundwork for development of a truly integrated plastic surgery residency – a model that is used in many integrated programs today.

The Division's role as an international leader in plastic surgery innovation and residency training continues today under Dr. Susan E. Mackinnon. Most recently, Mackinnon performed the world's first donor nerve transplant – a procedure that can save what were previously considered irreparably damaged limbs. In the residency program, 65 residents have been trained in plastic surgery since 1972. Thirty-one of those trainees have gone on to complete fellowships in hand/microvascular or craniofacial surgery.