MAy 2 014
P lastic , A esthetic ,
R econstructive Surgery
Plastic Surgery A n n u a l
N e w s l e t t e r
University of Miami Health system | MILLER SCHOOL OF MEDICINE
Progression in Leaps and Bounds by Seth R. Thaller, Chief and Professor
challenging problems with silicone toxicosis. Dr. Askari is developing protocols for possible hand transplantation. Dr. Oeltjen continues to work with our colleagues primarily in surgical oncology to use the latest reconstructive microsurgical techniques for post oncologic reconstruction. Our academic output from both our full-time and voluntary faculty remain outstanding. At the last ASPS in San Diego, three of our full-time faculty were able to share their clinical expertise as speakers in a variety of settings with their plastic surgery colleagues. Dr. Onelio Garcia was the 2013 recipient of the ASAPS “Tiffany Award” for the best scientific presentation of the year. Dr. Stuzin has continued the years of excellence for the Baker and Gordon meeting. This annual meeting in Miami remains in the forefront Another academic year has passed. We have of aesthetic surgery education. Each year, successfully faced the new challenges associparticipants are able to learn and share ated with a large urban academic medical center. In spite of this interesting environment with pioneering contributors to cosmetic we continue to be productive in all arenas. Our surgery in an interactive environment as well as closely observe the actual surgical program has been able to maintain a legacy procedure. Our division is fortunate to be of innovation, academic productivity, clinical excellence, and graduation and recruitment of able to co-sponsor this outstanding meeting and provide our residents with a unique excellent residents. educational opportunity. These are just a few Our basic science laboratory in collaboration of the academic highlights for our division. with Dr. Sharon Elliott continues to pursue answers to why is there a gender difference in Clinically, we work closely with colleagues in other specialties at a variety of hospitals on aging and wound healing. The goal is to develop effective translational laboratory results campus. that may be utilized within the clinical arena. Dr. Panthaki has established an outstanding Our full-time research fellows Drs. David Gerth clinical program at our Miami Veteran’s Adand Jun Tashiro are also simultaneously exam- ministration Medical Center. He has expanded ining the potential employment of stem cells in the breadth and reach of the clinical material management of cleft lip and palate. Clinically, for our service in the areas of hand and upper Dr. Salgado is pursuing clinical innovation extremity. We have worked closely with the in the use of fat stem cells to manage the regional spinal cord unit to provide interdisci-
plinary care to our paralyzed veterans as well as reconstructive options with surgical oncology, orthopedics, otolaryngology, neurosurgery, and cardiac surgery. At UMH, Dr. Salgado has involved the expertise of our faculty in the wound care clinic, hernia institute, and transgender surgery. Dr. Oeltjen has expanded the options for women undergoing breast reconstruction at Sylvester Comprehensive Cancer Center. Dr. Kassira continues to develop and expand the reach of our staff clinic and service at Jackson Memorial Hospital and Dr. Askari works closely with our colleagues on the JMH hand service to ensure a plastic surgery perspective on these challenging patients. This year also marks a new resident experience. Our graduating class for this year will have been the first that remained with us for a total of three years. This was instituted by the ACGME. These residents had an opportunity to rotate with nontraditional plastic surgery rotations such as dermatology, oral surgery, oculoplastic surgery, and anesthesia. Such experience worked to cement these clinical and academic relationships and introduce new referral sources as well as enhance their overall educational knowledge. This year we also accepted the first batch of applications for our newly accredited integrated plastic surgery program. Initial evaluation of the applicants was truly overwhelming in number and almost awe inspiring in quality of credentials. From our vantage, plastic surgery will maintain a lofty position at our institution for years to come. Notwithstanding our current crop of residents already in our independent program, incoming and current applicants also reflects the continued promise for our specialty. Continued to next page
Progression in Leaps and Bounds As academic plastic surgeons, we are full-time members of a medical school. We take tremendous pride in our responsibility to our students. We are now able to have regular rotations for third and fourth year students. Each student can chose our service for requisite surgery rotation. This has been exceedingly well received and remains a very sought after rotation. Dr. Wrood Kassira has taken on this responsibility and elevated our position within the medical school community through her commitment and efforts of formalizing the rotation. We also provide educational resources and assistance to the Plastic Surgery Interest group which has a robust and active membership. The highlight remains our annual suture course for the first and second year students as well as opportunities for a wide range of divisional activities. Fundraising has become a significant need
to develop the necessary resources to pursue our perpetual academic and clinical excellence. We now have two regularly scheduled annual events. Spreading Smiles luncheon and silent auction in Palm Beach and our 5 K Miles for Smiles in Aventura. These funds continue to enhance our cleft clinic, cleft patient care, education, and research. These important activities have been further enhanced by a generous gift by The Samuel J. and Connie M. Frankino Foundation that sets the stage for our cleft challenge. These fundraising activities have enabled the division to construct “The Samuel J. and Connie M. Frankino Cleft Lip & Palate Resource Library” adjacent to our interdisciplinary cleft clinic on the first floor of the Mailman Center for Child Development. Our goal is to empower patients and their families to learn more about their anomaly and fully participate in their
comprehensive care. As one can fathom, our division remains deeply involved with all facets of the Miller School of Medicine and neighboring Miami Plastic Surgery communities. This success is directly dependent on our team. This includes our full-time faculty, participating voluntary faculty, and hospital support staff at all of our affiliated hospitals as well as our office support staff. Without their effort and dedication we could not have reached this lofty position. For this reason, I extend my heartfelt “Thank you”. Lastly, although by the calendar, our 50th anniversary was in 2013, we held our actual celebration on Saturday, February 15, 2014 in honor of our outstanding alumni and friends in association with the Baker and Gordon Meeting.
Plastic Surgery Faculty Updates: Zubin J. Panthaki, MD:
John C. Oeltjen, M.D., Wrood M. Kassira, M.D., Christopher J. Salgado, M.D., Morad Askari, M.D., Seth R. Thaller, M.D. and Zubin J. Panthaki, M.D.
Dr. Panthaki continues to maintain one of the busiest practices in the division. His practice is equally split between breast cancer reconstruction and hand surgery. In addition to his clinical practice, Dr. Panthaki is also very involved with resident and fellow education, being the Associate Program Director for the plastic surgery residency program and the Program Director of the hand surgery fellowship program. He serves on committees of numerous national, regional and local Plastic Surgery and Hand Surgery societies. Having been promoted to the rank of full Professor of Clinical 2
Surgery last year at the University of Miami, Dr. Panthaki’s role has gradually transitioned to a mentorship role for junior faculty both in hand surgery and plastic surgery. As chief of hand surgery and plastic surgery at the Miami VA Hospital, a large part of Dr. Panthaki’s practice is devoted to care of our nation’s veterans. Furthermore, as chief of hand surgery at University of Miami Hospital, which is the University of Miami’s flagship hospital, our hand surgery practice has gradually evolved to offer some of the most advanced reconstructive techniques available.
UM Plastic Surgery Faculty Updates:
The hand fellowship at the University of Miami-Division of Plastic Surgery has developed into one of the leading hand fellowships in the country. We now attract the best and brightest from around the country including our current, excellent orthopedic trained hand fellow, Dr. Laura Tharp who graduates this year from our program and Dr. Ali Soltani, who graduated last year. Ali has started practice in California, and Laura plans to return to Georgia on completion of her fellowship to start an active clinical practice.
Duke University, an IRB approved retrospective chart review of our experience with prophylactic antibiotics in tissue expander and acellular dermal matrix breast reconstruction was published in March, 2013 in the Plastic and Reconstructive Surgery Journal. The results, which demonstrate a significant reduction in infection rates if prophylactic antibiotics are given for at least 48 hours postoperatively, bring into question the applicability of the Surgical Care Improvement Project (SCIP) antibiotic protocol to implant based breast reconstruction.
Last year our Hand Fellowship participated for the first time in the Combined Musculoskeletal-Hand Surgery Matching Program (CMMP) of the National Resident Matching Program (NRMP). We attracted our first choice candidate, Dr. Keith Aldrich, who comes to us from Baylor College of Medicine in Houston, Texas where he completed orthopedic training. He previously graduated with high honors from Michigan State University and then proceeded on to Harvard Medical School. He was awarded the Howard Hughes undergraduate research scholarship in 2002 and during his medical school education in Boston; he performed basic science immunocellular research in the dermatology department. After completing a preliminary general surgery resident year at the Massachusetts General Hospital he then went to Baylor College of Medicine for his orthopedic residency.
My reconstructive practice also includes lower extremity salvage with local and free flaps, to abdominal wall reconstruction, to complex facial fracture repairs. The past year has also included continued collaboration the Oral Maxillofacial Surgery Division, in the reconstruction of mandibular osteoradionecrosis using a combination of soft tissue free flap transfers with bone grafting and bone morphogenetic protein (BMP).
John C Oeltjen, MD, PHD:
Christopher J. Salgado, MD:
From all-terrain vehicle accidents on exclusive Bahamian estates to neglected and extensive malignancies, the unique medical environment centered on the University of Miami/Jackson Memorial Hospital Medical Center provides abundant and nearly boundless opportunities for the plastic and reconstructive surgeon. Approaching each case with the goal of re-establishing function and form, my practice focuses on providing reconstructive support for our colleagues in Surgical Oncology, Orthopedic Surgical Oncology, Gynecologic Oncology, Colorectal Surgery, Orthopedic Trauma Surgery, Vascular Surgery, Oral and Maxillofacial Surgery, and Trauma Surgery services.
Dr. Salgado was promoted to Professor of Clinical Surgery this past year.
Importantly, as taught with the reconstructive ladder, plastic and reconstructive surgery is more than implants, microsurgery, and flaps. An in depth knowledge of circulation and basic wound healing principles in combination with comprehensive and meticulous pre- and post-operative care are the pillars of my practice and of the resident educational experience.
Obtained grant from KCI to evaluate the effectiveness of the UltaVAC with instill vs. no instillation of prontosan (antiseptic). Outcomes measured will be the number of return to operating room for operative debridement’s prior to closure and evaluation of bacterial load between two therapeutic options. This is a multi-institutional study and the University of Miami is involved along with Northwestern, Georgetown, and the University of Texas Southwestern. The grant is for 326K over one year. We will be hiring a Clinical Research assistant to assist in this study.
Surgical Oncology remains a primary focus with a specialization in breast reconstruction for breast cancer patients at Sylvester Comprehensive Cancer Center, patients referred from the surrounding communities, the Caribbean, and Central and South America. To these patients, I offer the full range of breast reconstruction from perforator free flaps to implant based reconstruction. Utilizing continued evaluation of post-operative results, input from a nationwide panel of experts in the field, and implementation of state of the art techniques, I am expanding the indications for immediate reconstruction in the hopes of decreasing the psychological impact of a mastectomy. In my practice, increasing use of nipple sparing mastectomies, use of contoured form stable breast implants, and use of adjunct fat grafting to contour irregularities, have elevated the standard “reconstruction of a breast mound” to “reconstruction of an aesthetically pleasing breast.”
The University of Miami Hernia team is continuing their multidisciplinary efforts seeing patients in consult with the general surgery team at the University of Miami Hospital and Clinics every other Friday and is a practice which has now become a national referral center for other institutions. Surgeries are conducted at the University of Miami Hospital. The University of Miami Genital and Transgender Surgery Group has now expanded its services to include insured patients with transgender surgery desires to complete their transition process. It is the only transgender team in the nation which offers the entire scope of transgender care including a urologist, ob/gyn, psychiatrist, colorectal surgeon, pelvic floor therapist, and plastic surgeons. The team offers ALL services in transgender care which makes this team unique in the nation.
With the diligent work of Yash Avashia, a University of Miami medical student who is now a 1st year Integrated Plastic Surgery resident at 3
UM Plastic Surgery Faculty Updates: Wrood M. Kassira, MD: JMH Clinic and Staff Aesthetic Clinic On Wednesdays, you can find the plastic surgery residents busy seeing patients at the Jackson Memorial Hospital Plastic and Reconstructive Surgery Staff Clinic in ACC West. For years, the residents have provided quality medical care under the supervision of the faculty of the University of Miami, Division of Plastic, Reconstructive and Aesthetic Surgery. The clinic remains busy and the residents are able to care for many patients with a wide range of reconstructive problems, from facial fractures, to breast cancer reconstruction, skin cancer defects, lower extremity wounds, breast reductions and abdominal wall reconstruction. Drs. Wrood Kassira and Morad Askari supervise the Staff Clinic and they, along with our other faculty, staff the surgeries at Jackson Memorial Hospital. Drs. Peter James, Alan Rapperport, Steven Schuster and Jay Ellenby at times also staff the clinic, having done so for several years. The clinic is fortunate to have a well-equipped minor surgical operating room. This allows residents to gain hands on experience with smaller types of cases, which is another dimension of their training. In addition, the cosmetic practice continues to flourish. A patient interested in cosmetic surgery is seen in consultation and an individualized plan tailored specifically for that patient is designed. Some of the surgeries offered include breast augmentation, breast lift, facelift, rhinoplasty, blepharoplasty, liposuction and abdomi-
noplasty. Patients are offered surgery in a hospital setting at affordable prices by a dedicated surgical team. The clinic continues to be invaluable to the many patients served at Jackson Memorial Hospital and it is also invaluable to the residency experience, allowing residents to establish a diagnosis, formulate a treatment plan, utilize ICD-9 and CPT coding, become skilled in the postoperative management of a myriad of procedures and see long-term results, all under the direct supervision of our faculty. This clinic facilitates the transition from being a resident to becoming an independent practitioner of plastic and reconstructive surgery once residency is completed.
Morad Askari, MD: In the past year, the brachial plexus clinic at the University of Miami has continued to grow. Through this clinic, the patients are offered a full spectrum of reconstructive options ranging from nerve reconstruction to nerve and tendon transfer as well free functional muscle transfers. Jackson Memorial Hospital hand service continues to be busy with general upper extremity trauma as well as complex soft tissue and bony reconstruction while the hand service at Bascom Palmer Institute provides a balance of chronic and subacute upper extremity disorders. At the same time, the Composite Tissue Transplantation Project is well underway and prospect of a hand transplant in the coming year is becoming a tangible reality.”
Plastic Surgery Residents
Graduating Class of 2014 published a number of peer-reviewed articles, as well as, textbook chapters in basic science, General Surgery and Plastic and Reconstructive Surgery. Ari has been very productive over the past two years, publishing many more chapters, as well as, compiling and editing a new textbook on Plastic Surgery, titled “Operative Procedures in Plastic, Aesthetic and Reconstructive Surgery,” scheduled for publication in December, 2014. After completion of his residency, Ari plans to pursue a practice with a combination of reconstructive and aesthetic surgery in private practice. Definitely interested in incorporating microsurgery into his practice. If you ask Oeltjen, Kassira and Askari, they will say that he can operate independently.
Urmen Desai, M.D., Jason Edens, M.D., Ari Hoschander, M.D.
During his residency, Ari has developed a mini aesthetic practice bringing patients into the staff clinic for cosmetic surgery, as well as, patients for injectables.
Ari Hoschander, MD: Ari Hoschander is currently one of the Chief Residents in the Division of Plastic and Reconstructive Surgery. He has previously 4
Plastic Surgery Residents Jason Edens, MD:
profiled on CNN and numerous other national news outlets for his contribution in the reconstruction of a patient who suffered a horrific facial mauling incident which gained worldwide acclaim in the last year. Additionally, he has completed four textbook chapters and has taken on three research projects with our faculty. Most recently, Dr. Desai had his research titled: “Liposuction and Lipofilling for the Treatment of Symptomatic Silicone Toxicosis of the Gluteal Region” accepted to the journal Aesthetic Plastic Surgery. Furthermore, Dr. Desai took his third trip to Port-au-Prince, Haiti performing cleft lip and cleft palate reconstruction with Dr. Thaller. Upon graduation this June, Dr. Desai will be starting his own boutique aesthetic plastic surgery practice in Beverly Hills, California.
Jason Edens has enjoyed his training in Plastic Surgery in Miami and has been amazed at the diversity of patients and procedures that the program offers. He also enjoys being in the Miami area with its wide variety of activities. Upon graduation in June, Jason will return to active duty in the US Army at Landstuhl, Germany, serving the military as a Plastic Surgeon, focusing on trauma and burn reconstruction in soldiers injured during the current conflicts. Following fulfillment of his military obligation, he plans to return to Oklahoma and go in to private practice.
Urmen Desai, MD: Urmen Desai once again has been extremely productive in his chief year as a Plastic Surgery resident. His year began by being
Graduating Class of 2015 Tuan Tran, M.D., Anselm Wong, M.D., Rizal Lim, M.D. Rizal Lim, MD:
Anselm Wong, MD: Anselm is in his second year of training and is continuing to expand his knowledge about the vast field of plastic surgery. He is enjoying the wide variety of procedures that the program offers, learning new techniques and solidifying the others. He still misses the New England seasons and snowboarding, but has been bicycling more and more when he occasionally has free time. Anselm’s future career plans are to pursue a practice divided between plastic and hand surgery, preferably returning to the Northeast area but bringing some of the Miami sunshine with him.
Tuan Tran, MD: Tuan is inspired to pursue a career in global plastic surgery after his service trip in Haiti. Residing in Miami Beach, he embraces the vibrant and diverse culture. He is grateful to be part of a residency program with strong staff of diverse backgrounds and specializations.
Rizal is progressing through his second year in the program. He completed medical school at University of Toledo Medical College of Ohio as Presidential scholarship recipient and thereafter completed his General Surgery training at Boston University including a 2 year surgical research fellowship.
At this time, Tuan is interested in all aspects of plastic, reconstructive, and hand surgeries with the goal of being efficient in procedures to better serve his global health objectives. Upon completion of his three-year residency, Tuan plans to pursue a hand surgery fellowship. Beyond that, he plans to practice general plastic/reconstructive surgery along with aesthetic and hand surgeries.
His interests at this point of his training include congenital as well as post traumatic Craniofacial Surgery. His future goal after completion of the program is to pursue further training in this subspecialty.
Plastic Surgery Residents
Graduating Class of 2016 Renee Gasgarth, MD: Renee Gasgarth has enjoyed her return to the Sunshine State and is interested in pursuing a career in breast and oncologic reconstruction.
Rebecca Baschuz, MD: Rebecca Baschuz is a first year resident from Detroit, Michigan. She is board eligible in General Surgery after 5 years of training at Wayne State/Detroit Medical Center. She is enjoying the start to her first year, completing the Orthopedic Hand rotation, and now currently very busy at University of Miami/Jackson Memorial Hospital, with a wide variety of breast and general reconstruction cases. Interested in a broad range of Plastics,
Rebecca is keeping her mind open to additional fellowships on completion of Plastic Surgery and would like to have a very diverse clinical practice.
Bryan Curtis, MD: Bryan Curtis has enjoyed the learning opportunities provided in his first few months in Miami. He is currently on the Hand Service where he is gaining great exposure to trauma, malignancy, and benign pathologies. He is keeping himself occupied by working on a couple of research projects, one of which he recently presented at the Florida Society of Plastic Surgeons meeting. He’s looking forward to jumping back into breadand-butter plastic surgery in the second half of the year, and hoping to get more
Rebecca Baschuz, M.D., Bryan Curtis, M.D., Renee Gasgarth, M.D.
experience with aesthetics. During non-working hours, Bryan would like to catch a few Heat games and take advantage of the great winter weather with some running.
Incoming Residents 2014 David Michael Fourqurean, MD: Michael was born in Parkersburg, WV. He has always gone by his middle name Michael or “Mike”. He attended college at West Virginia Wesleyan College, where he studied chemistry. During this time he was active in the music department as a member of the saxophone ensemble and guitar ensemble. After college, he went to West Virginia University School of Medicine and graduated in 2009. After medical school he was accepted as a general surgery resident in the West Virginia University School of Medicine Department of Surgery. It was during that time that he met his wife, who is a critical care nurse. They were married in September 2012. He will finish his training in general surgery in June 2014. In his spare time he enjoys playing golf and guitar. Plans for residency: His plans for residency include becoming a highly valued member of the plastic surgery team as well as participating in research. Michael also hopes to learn all that he can both in the operating
room and out of the operating room. He is very interested both in microvascular reconstruction and hand surgery, and is looking forward to developing his clinical decision-making skills as well as operative skills in those areas. At the completion of his plastic surgery residency, Michael plans on pursuing an academic career.
Ajani Nugent, MD: Ajani comes to us by way of Atlanta, where he has resided since finishing medical school at University of South Florida in 2007. While in Georgia he completed residency in Otolaryngology, followed by a head and neck oncology/ microvascular fellowship, both at Emory School of Medicine. Nearing the end of his training he realized that he wanted to expand his reconstructive skills beyond the head and neck and decided to pursue full body reconstructive surgery here at University of Miami/Jackson Memorial Hospital. He is also enthusiastic about returning to Florida to be closer to his family in South Florida and Jamaica. Currently he is interested in the full 6
breadth of plastic surgery, and actually went on his first surgical mission trip to Haiti with the University of Miami team this past November. Once starting plastics training, he hopes to balance his training in Miami, with regional and national involvement with resident education and experience. With his remaining spare time he enjoys water activities, soccer and following formula 1 grand prix.
Nicholas Galardi, MD: Nicholas was born in Pittsburgh, PA, and grew up Wheeling, WV. He completed a BS in Biochemistry at the Bethany College in WV, graduating with honor and then attended and graduated from West Virginia University School of Medicine. Nicholas then completed a General Surgery Residency at Eastern Virginia Medical School located in Norfolk, VA. He has met the mandatory case requirements to sit for the general surgery board exam. His hobbies include sports, weight training, cooking and riding motorcycles. Nicholas’ current professional interests are in facial reconstruction, hand surgery and aesthetic surgery.
Plastic Surgery Residents and Fellows
The Division’s First Integrated Program Resident in 2014
Laura Tharp, MD:
Laura Tharp’s future plans are in the planning state. She is currently interviewing for hand surgery/ortho positions. Laura plans to stay in the southeast (GA/SC/ North FL).
Steven Ovadia is currently a 4th year medical student at the University of Miami Miller School of Medicine. Steven is the oncoming PGY-1 integrated plastic surgery resident starting July 1, 2014. In his free time, Steven enjoys working on research, weightlifting, and spending time with his family.
Basic Science Research investigations in the mechanisms of stem cell function relating to wound healing and congenital malfmorations, and have submitted a grant application to investigate tissue engineering in cleft palate repair. Additionally, our lab continues to focus on disease disparities relating to age, continuing with our interest in age-related changes in stem cells. Our goal remains to translate our molecular and cellular investigations into advances in clinical medicine. We have been involved in several clinically oriented projects as well. Utilizing the National Cancer Institute database, we have been able to describe the epidemiology and outcomes relating to surgical management in several pediatric malignancies on a much larger scale than in the existing literature. We are also currently in progress of building a pressure ulcer database. Our aim is to better understand the relationship between nutritional status and surgical outcomes in these challenging cases.
Jun Tashiro, M.D. and David Gerth, M.D.
Our lab is moving forward with several exciting projects with the promise of clinical application. We have continued our
HISTORY OF THE SOUTH FLORIDA CLEFT AND CRANIOFACIAL CLINIC The mission of our clinic is to assist our families and patients and provide a comprehensive cost effective multi-specialty treatment plan . History: Our clinic was initiated in 1951 by a group of health care specialist whose primary goal was assisting families and their children who were born with cleft lip/palate. In the early 50’s during a study course conducted by the Dade County Research Clinic, a group of likely minded dentists met with Dr. Cloyd Harkins who was an internationally known expert in the field of dental prosthesis and Cleft Palate. This group of Dentists eventually invited a number of like-minded specialists from Medicine, Pediatrics, Plastic Surgery and Speech, to provide further evaluation and management. Very soon, the cleft palate was formed at Variety Children’s House to provide consulting services in diagnosis and planning of rehabilitation. The location since the inception remains the Mailman Center for Child Development, which is an integral part of the University of Miami/Jackson Memorial Hospital Medical Center complex. In 1954, The Soroptimist Club of Coral Gables, a service club for business and professional women was searching for a club project. This group can take some credit for helping to further organize and finance the clinic for an extended period of time. In 1959, the clinic was incorporated under the laws of the State of Florida, with
a board of directors composed of community leaders. The location was eventually moved to the Mailman Center for Child Development, which continues to be an integral part of the University of Miami/ Jackson Memorial Hospital Medical Center complex. The clinic continued to develop and expand and in the 1960’s, the clinic was under the directorship of Dr. D. Ralph Millard who made many significant contributions to the field. In 1995, the clinic came under the auspices of the UM Department of Pediatrics and Genetics. Dr. Ron Haun continued to develop and expand the breadth of the clinic until his untimely death on March 1, 2000. In 1997, the clinic celebrated with the first annual Picnic. Following in the tradition of expert leadership of Dr. Haun, the clinic came under the guidance of a number of pediatric specialists. Today it is directed by Dr. Stephanie Sacharow and continues to provide exceptional interdisciplinary care to our patients. We have enhanced our financial capabilities with two annual events: our annual 5K “Miles for Smiles” Run in June and Spreading Smiles in Palm Beach in this coming April. These fundraising events have culminated in our first annual Dr. Ron Haun lectureship by Dr. Ian Jackson. We had our inaugural opening of the Samuel J. and Connie M. Frankino Cleft and Palate Resource Library on December 17, 2013.
Grand Opening of the Samuel J. and Connie M. Frankino Cleft Lip & Palate Resource Library on December 17, 2013 at the Mailman Center for Child Development
2nd Annual Cleft Lip & Palate “Miles for Smiles” 5K was held on
June 9, 2013 at Aventura Mall
The next Division of Plastic Surgery “Miles for Smiles” 5 K will be held January-February, 2015 “Help us meet the Cleft Challenge” in an effort to support education and prevention as well as help fund research efforts to improve advanced surgical techniques. If you would like to donate, please contact Cory Witherspoon at 305-2434150 or email him at: [email protected]
The Division of Plastic, Aesthetic and Reconstructive Surgery
“50th Golden Alumni Reunion Anniversary Dinner” The Division of Plastic, Aesthetic and Reconstructive Surgery “50th Golden Alumni Reunion Anniversary Dinner” was held on February 15, 2014 at the Hyatt Regency Downtown Miami
The following were our honorees: Thomas J. Baker, MD, Gary Burget, MD, James M. Stuzin, MD, Sabrina A. Lahiri, MD, Jose “Joe” I. Garri, MD, DMD, Arlene Desiderio, Maribel Santa Cruz, MD, Samuel F. & Connie M. Frankino Charitable Foundation, KLS Martin Corporation and The Haun Family
Visiting Professors 2013-2014
Dr. Maria Siemionow, March 20, 2013
Dr. Gregory M. Buncke, October 2013
Dr. Renalto Saltz - ASAPS Visiting Professor, September 11, 2013
Alan Matarasso, M.D., F.A.C.S. presentation at our Grand Rounds, December 4, 2013
Eye on Haiti Urmen Desai, MD, MPH Chief Plastic Surgery Fellow
three operating days allotted to our team. The case load included 9 cleft lip repairs (6 primary unilateral, 1 primary bilateral, 1 microform, and 1 revision unilateral), 11 cleft palate repairs (8 primary, 3 staged), 1 hydrocele and 1 tooth extraction. Despite these impressive numbers over a very short operative period, we were more pleased with the fact that of the 22 cases performed, we returned back to Miami without any complications.
The Division of Plastic, Aesthetic, and Reconstructive surgery returned to the Bernard Maves Hospital in Port-au-Prince, Haiti once again this academic year, led by Dr. Thaller. Not only were we able to screen a number of new patients with craniofacial anomalies, but we were also fortunate to see the patients who we had previously operated on from our mission one-year prior. In several instances, we were able to perform a second stage procedure or repair a palate defect after previously repairing a lip defect the year prior on the same patient. Upon immediate arrival into Port-au-Prince, we screened 35 patients, performed 22 procedures on 19 patients in the
The Division continues to be dedicated to the people of Port-auPrince and the Bernard Maves Hospital. We look forward to our return mission in the next academic year to a community who continues to depend on our persistent dedication and support
Surgical Mission Trip to Port Au Prince, Haiti by Catherine Gordon, University of Miami School of Medicine MD, Candidate, Class of 2015 After transporting one of our cleft palate babies to recovery and pleased with the job the residents had done, I walked across the road to the main office. I was told to get vitals on a cleft lip case that we planned on adding to our schedule. Someone had called the day before to confirm that we could see the patient. The only information we received was that he was a cleft lip case. I walked into the office and saw a tall 28 year old man sitting uncomfortably, ringing a baseball cap in his hands as his eyes darted around the office. It was impossible to miss his large right sided cleft lip. He was obviously uncomfortable showing himself in public. I had never seen a cleft lip with such pronounced anatomy. After sitting down with our clinic and PR coordinator, and now personal translator, she told me while he was sitting outside waiting to be evaluated, that very baseball cap had been covering his face instead of sitting on his head. I continued to ask questions to get to know this man before we operated on his lip. I hoped to bring him some self-esteem and happiness.
told that I would have to wait until a doctor from another country could fix it. We lived far away. I waited but no one came to fix me. Q: How did people treat you growing up? A: People called me evil without ever meeting me. People cursed at me. Q: Did you know anyone else who had a cleft lip or palate? A: There was one other girl in my town. I have not seen her in 10 years. I don’t know if she died or what. Q: Did you go to school? A: My parents did not think I was ready for school so I did not attend first grade until I was thirteen. I stayed in school for five years but could not afford it so I left. Q: What do you do for a living now? Do you work? A: I used to pick up jobs and errands from people and get paid, then look for more. Now I go fishing and try to sell the fish to people.
Q: Where are you from and how did you get here? A: I am from a town about 3 hours away. I rode a tap-tap then took a motorcycle from the middle of the city to the hospital. (of note: “tap-taps” are colorful pick-up trucks with seats built into the back. People simply tap the truck to be picked up, pay for their trip, and hop off. He had ridden a tap-tap for over 3 hours just to come to the hospital.)
Q: Who or what has helped you get through these tough times? A: My neighbor. He always told me to keep faith and not to listen to the other people. I knew someone would help me someday. I had faith. And now that day is today. Q: How did you hear about us coming to this hospital? A: My friend heard about the doctors on the radio. She told me then she called for me.
Q: Tell us about growing up with a cleft lip. A: My parents took me to multiple doctors. They had always been 12
Eye on Haiti
Surgical Mission Trip to Haiti Q: What are you most excited about after the operation? A: I am so excited. I just want to scream. I am just so excited.
tude that they sent, all made the trip enjoyable and fulfilling. Meeting this man, hearing his story, completing a complex operation, and knowing what a huge difference we made in his life – made the trip priceless.
The entire trip to Haiti was an eye-opening and rewarding experience. Seeing the look on mother’s faces when we handed them their children after an operation, and reading the emails of grati-
Haiti – a medical student’s perspective by Kriya Gishen, Candidate Class of 2015
But, when an adult man with a cleft lip sits before you with tears streaming down his cheeks because he cannot contain his excitement that “today is the day that the rest of his life begins” you become acutely aware of the primary reason you have traveled to a country plagued by poverty and by crime. Of the many cleft lips and palates patients we encountered, this man was the only adult. So, for the first time, I witnessed what life without a repair might look like: constant mocking, an education cut short, extreme poverty, social stigmatization and the deep emotional scars of rejection. In one man’s face, in one cleft lip, I understood what each baby on whom we were operating would be spared of. A 2 hours surgery suddenly made a lifetime of differences. I felt a bit of what every parent sitting with a crying hungry, baby in that dusty courtyard waiting for hours after a long, arduous journey was feeling: hope for a better future.
They are called “Tap-taps,” the brightly painted open back trucks that transport passengers through the dusty street of Haiti. A traveler taps the side of the vehicle to board, pays, rides and then taps to jump off at a desired destination. For one particular man who sat with his face shrouded by an American baseball cap, that destination was the Bernard Mevs hospital in Port-au-Prince. He sat in the waiting area, an open-air courtyard between the four small buildings that function as the hospital’s operating rooms, examination rooms, offices, in-patient and recovery rooms. His cap hid the cleft lip that had stigmatized him throughout his childhood and adult life. He had traveled for several hours from a rural area, driven by an unfaltering hope that the “American doctors” could give him a new face and in turn change his life’s course. His unwavering faith in humanity and in his surgeons, despite the many hurdles of his youth, was humbling.
Haiti, the poorest nation in the western hemisphere set against the backdrop of green mountains bordered by ocean, represents a dichotomy of extreme human suffering and extreme human faith. For me as a medical student, it reignites the desire to help other people, that humanitarian instinct that underscores the decision of most physicians to embark on medical careers. One man’s cleft, one failure of fusion during embryogenesis, one encounter, changed every other surgery for me thereafter. Every baby carried to the operating room, every parent reassured with a smile in place of the creole words that I lacked, every 15 blade scalpel opened and every suture thrown, further defined surgery as an art of soul and of science and as a learned skill that gifts the surgeon with an opportunity to craft another man’s smile.
This man’s journey was, for me as a medical student who had traveled to Haiti once before with the Division of Plastic Surgery, the single most eye-opening patient encounter. This man embodied, in totality, the objective of a surgical mission trip. Yes, mission trips do provide an outstanding and unique educational experience to residents and medical students alike. The challenges of practicing medicine and performing operations in a third world country with limited recourses provides an unparalleled opportunity to acquire surgical skills and to develop as a physician, a leader, and possibly even a person of higher moral character. Mission trip teach participants to practice in a professional, culturally sensitive and ethical manner.
Plastic surgery NEWS Voluntary and community physician news Buster Mullin retired on July 31, 2013.
M. Felix Freshwater had 18 PubMed listed publications in the 2012-13 academic year. In addition to maintaining his editorial board memberships for JPRAS, HAND and the Journal of Hand Surgery (Eur), Felix accepted an invitation to join the editorial board of Annals of Plastic Surgery. Felix is continuing his research on the history of plastic surgery and in June he was permitted to examine the original correspondence between Sir Harold Gillies and Ralph Millard from 1947 to 1951 kept in the Gillies Archives at the Royal College of Surgeons in London. Alan Rapperport: Nice to be back with The Program after two dissecting Aortic Aneurisms and an occluded Rt Iliac artery. Yes sir “ It’s good to be on this side of the grass”! Onelio Garcia, M.D. Analysis of Acellular Dermal Matrix Integration and Revascularization Following Tissue Expander Breast Reconstruction in a ClinicallyRelevant Large Animal Model. . Plast Reconstruct Surg. 2013;131:746 Onelio Garcia, M.D. The effects of NonFocused Ultrasound on Tissue Temperatures and Adipocyte Morphology. Aesthetic Surg J. 2013;33:117-127. Onelio Garcia, M.D. Liposuction of the Upper and Lower Extremities. In Ali A, Nahas F, (eds ) The Art of Body Contouring: A Comprehensive Approach. 1st Ed. Quality Medical Publishing, St. Louis, MO. 2014 (awaiting publication)
Past Hand Fellow Update Ali Soltani, MD: After a short 6 month stint at the VA Southern Nevada/University of Nevada Ali was recruited to Kaiser Permanente Orange County. His family is excited to be returning home to sunny Southern California. Ali and his wife Kelly are busy taking care of their two children, AJ age 8 and Izabella age 10 months.
Past Research Fellow Update David Pincus, MD: After graduating from the University of Miami general surgery program, David began a plastic surgery fellowship at Lahey Hospital and Medical Center in Burlington, Ma. He is now in his second year of plastic surgical training. On a personal note, David and his wife Lisa recently gave birth to their second son. David is now beginning the process of looking for employment after fellowship.
Congratulations to Piotr Skowronski, M.D. for passing his American Board of Plastic Surgery Written Exam Past Resident update: Tarik Husain, MD : Tarik Husain, MD (2012 JMH/UMH plastic surgery graduate) is currently in his first year of private practice, based out of Miami Beach after having completed his hand/microsurgery fellowship at the University of Texas Southwestern in Dallas, TX. He is actively practicing plastic surgery which consists mainly of hand to shoulder, reconstructive, aesthetic, and facial trauma. He has passed his written board exam and is currently in the collection process for his oral board exam this year. He has managed to get busy in the competitive Miami job market having completed over 80 surgical cases in a four month span. He also works part time at OrthoNOW providing hand and upper extremity surgery coverage in Doral for an Orthopaedic urgent care center. The past year he has had multiple publications in peer reviewed journals. He has maintained strong ties to the University and assists in teaching residents and attending Grand Rounds. He continues to snowboard, lift, and run in his limited free time.
Plastic Surgery Events
UM Division of Plastic Surgery VEST PROGRAM for International Scholars
interview on CNN August 21, 2013
The division has initiated a new program in order to help with research, resident/fellow research/education support, graduation events, fund raising activities, necessary equipment. One of our 1st scholars is Dr. Ling who will be with us for one year. “Dr. Ling Tao is from Chongqing, China where she works in a military hospital as an officer and plastic surgeon. She has been in practice for eight years working at the Southwest Hospital (the first affiliate of the Third Military Medical University) and was sponsored by her hospital to come to the University of Miami Division of Plastic Surgery for one year as a Research Scholar”. Further information about the VEST program can be found on the University of Miami Division of Plastic Surgery website.
PLASTICS PARTICIPATION IN THE Susan G. Komen “race for the cure” 5k October 19, 2013 at Bayfront Park, Downtown Miami.
Plastic Surgery Events
Plastic Surgery Residents and Hand Fellow “Welcoming Party” Held at the Four Fillies Farm November 24, 2013
Research Fellows Jun Tashiro and David Gerth Left to right, Renne Gasgarth, Rebecca Bachusz, Bryan Curtis and Laura Tharp
Options and Challenges” Dr. Oeltjen talk to the medical students, November 6, 2013 at Rosenstiel Medical Science Building
Faculty, residents and staff
Faculty, residents and Dr. Panthaki’s twin boys 16
Plastic Surgery Events
Annual Medical Student Suture Course Annual Medical Student Suture Course held at RMSB on November 19, 2013
cadaver Lab Workshop
kls Boot Camp
Cadaver Lab Workshop with Dr. Buncke, Faculty, Residents & Fellow held at the McKnight Center, October 2013
KLS Annual Resident Maxillofacial Virtual Boot Camp, October 2013
Plastic Surgery Staff Clinic at ACC-W 17
Plastic Surgery Events
Heroes for Hope
Journal Club sposored by Dr. James Stuzin
Plastics surgery participation in the Department of Surgery annual “Heroes for Hope” event held at Parrot Jungle, December 13, 2013
Journal Club sposored by Dr. Alan Serure
Deering Office recently received a facelift
HELP US MEET THE CLEFT CHALLENGE DID YOU KNOW... •C left Lip/Palate affects 6,800+ newborns in the US every year.
•K ids with cleft undergo many surgeries from birth to adulthood.
• Cleft affects speech, facial development and much more. The Cleft Lip and Palate Education and Research Fund in the Division of Plastic Aesthetic and Reconstructive Surgery at the University of Miami Miller School of Medicine
Your Gift Counts! By donating to the Cleft Lip and Palate Education and Research Fund at the University of Miami Miller School of Medicine, you can fund life-saving research and help our patients live longer, healthier lives. Your donation will not only support education and prevention, it will also help fund research efforts to improve advanced surgical techniques.
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Division of Plastic Surgery P.O. Box 016960 (R-88) Miami, Florida 33101
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