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members of the division’s research program is Xiaowei Li, PhD, who joins the Division of Plastic and Reconstructive Surgery as an assistant professor of surgery. His research aims to create bioengineering platforms for nervous tissue regeneration after injuries or diseases. “Together, Matt Wood and Amanda Westman have developed the research infrastructure to support future discoveries and innovations in plastic and reconstructive surgery,” says Sacks. “Our research fellows, investigators, clinical faculty and trainees benefit from having access to an organized, structured program of basic, translational and clinical research. Dr. Danika Kovachev joined the Plastic Surgery Service in the 1970s, and she played a major role in head and neck reconstruction. Dr. Ted Chaglassian was recruited to the Plastic Surgery Service in the 1980s and later became chief of the service. By then, myocutaneous flaps were used for reconstruction, and local and regional flaps were used for repair of surgical defects following major ablative surgery for head and neck tumors. During the 1970s and ’80s, the development of myocutaneous flaps, including the pectoralis major, latissimus, and trapezius flaps, allowed plastic surgeons to “close” very large defects in a reliable and effective manner. However, in many of these cases, the aesthetic and functional results were less than optimal. Dr. David Hidalgo was recruited in 1986 to bring microsurgical free flap reconstruction to Memorial Sloan Kettering. The introduction of free flaps completely revolutionized the capabilities of the Plastic Surgery Service to provide reconstructive support to head and neck surgeons. Microsurgical techniques were first applied to achieve coverage of massive scalp and midface defects, using large myocutaneous free flaps as well as more elegant reconstructions of nasal defects and cheek defects with thin cutaneous free flaps, often folded to provide both internal lining and external skin coverage. The ilium free flap was popular at the time for mandible reconstruction but had important technical and aesthetic shortcomings. This led Dr. Hidalgo to pioneer the use of the fibulaosteoseptocutaneous flap for mandible reconstruction. Dr. Hidalgo’s championing of mandible reconstruction using the fibula free flap was a major breakthrough, and the application of this technique was pivotal in advancing head and neck reconstruction. One of his key contributions was recognizing that the fibula could be osteotomized in multiple locations on the basis of its dual endosteal and periosteal blood supply. Although other osseus flap options existed, none had such a robust blood supply with a reliable ability to freely contour a piece of straight bone into the mandible parabola. Moreover, the associated skin island could be used to reconstruct contiguous soft tissue defects, both internal and external. Dr. Hidalgo perfected the operation through continual aesthetic refinements, using both acrylic templates derived from imaging studies and titanium miniplates to improve the accuracy of bone shaping, restricting facial incisions to the neck, and replanting the native condyle for extensive lateral defects. This raised the bar for the cosmetic and functional outcomes that could be achieved. In fact, the fibula flap has become the gold standard for mandible reconstruction worldwide as a result of these efforts at Memorial. Newer, more sophisticated algorithms for reconstruction of many areas of the head and neck, including the oral cavity, tongue, midface, maxilla, hypopharynx, and skull base, were introduced in the 1990s and by other surgical faculty. 3 Dr. Peter Cordeiro was appointed Chief of the service in 2001. Although advances in mandible reconstruction came first, no individual surgeon had amassed enough experience in maxillary reconstruction to devise a definitive algorithm. Most patients were not reconstructed with tissue but instead had obturators placed to seal the oral cavity. Peter Cordeiro’s fellowship background in craniofacial surgery and microsurgery, combined with the large number of ablative defects seen at MSK, created an ideal opportunity to advance midface reconstruction. His contributions include the establishment of proper orbital floor support with autologous bone grafting and manipulating, obliteration of surgical dead space with soft tissue replacement in anticipation of postoperative radiotherapy, the sandwiched osteocutaneous radial forearm flap for palatal bony reconstruction, and creation of multiple rectus flap skin islands to resurface both the nasal and the oral cavities. Dr. Cordeiro’s algorithm and conceptual considerations have moved maxillary reconstruction forward and serve as the standard of care in many centers. Memorial Sloan Kettering Cancer Center Dr. Cordeiro is also internationally recognized for his expertise in expander/implant breast reconstruction. He has been a thought leader on the use of implants in a variety of settings including patients who undergo postmastectomy radiation therapy. Dr. Cordeiro has also served as the primary investigator of a major clinical trial assessing the use of form stable breast implant. Dr. Disa joined the faculty in 1998 and has led a number of important initiatives. Dr. Disa developed a definitive algorithm for hypopharynx reconstruction, accurately describing the variety of defects present in this area, with
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