Plastic Surgery Division

by Dr. Nicholas Vedder, Chief

Nicholas Vedder, MD, Chief

The Division of Plastic Surgery continues to grow and expand in all three of our academic missions: patient care, education, and research. When I joined the UW faculty in Plastic Surgery in 1990, my sole colleague in the Division was my former Chief and the founder of the Plastic Surgery program at the UW, Dr. Loren Engrav. Since 1991, we have grown to our current full-time academic faculty of 12; we have three Plastic Surgery residents per year (total of 16); and seven clinical fellows per year, either in or affiliated with the Division.

The UW Division of Plastic Surgery is now widely regarded as one of, if not the top, Plastic Surgery program in the world, with leading clinical, educational, and research programs in all areas of Plastic Surgery. To serve the needs of the community and the region, multiple faculty are based at each of the four medical centers (HMC, UWMC, Seattle Children’s & the VA). Balancing the diverse needs of each location and assuring accomplishment of our mission in the current medical climate is an ongoing, but important and fulfilling, challenge.

Harborview Medical Center

The UW Plastic Surgery educational program continues to be based at Harborview, though the tremendous growth at UWMC, Seattle Children’s and the VA have broadened and fully balanced our educational program. For complex hand and extremity reconstruction, burns, facial trauma, and wounds of all types, Harborview remains the regional referral resource for the WWAMI region.

• Dr. Loren Engrav, who developed this referral center, has transitioned his clinical focus to one of basic research. He is funded by the National Institute on Disability and Rehabilitation Research and the National Institutes of Health, and is one of the NIH’s most senior first-time investigators.
• In 2004 we were fortunate to be able to recruit Dr. Matthew Klein to join the faculty. He continues the burn focus at Harborview and is intent upon augmenting and ensuring the future prominence of this world-class burn program. Matt is extremely successful in that regard; he has received his MPH and completed the UW KL-2 program. He now has a world class outcomes research program and was recently honored by receiving the David and Nancy Auth-Washington Research Foundation Endowed Chair for Restorative Burn Surgery. In addition, Matt has also taken over as Program Director of our Plastic Surgery Residency Program, which is a leading training program in the country.
• Another addition to the Harborview faculty is Dr. Jeff Friedrich  who joined UW Plastic Surgery in 2007.  Dr. Friedrich was one of our star residents, who then completed a hand surgery fellowship at The Mayo Clinic. Jeff joins me and our four full-time colleagues in Orthopedic Surgery as part of the UW Combined Hand Surgery Program. In addition to clinical activity, this collaboration trains four hand fellows a year. This is one of the best training programs of its kind in the United States and one of the best examples of interdepartmental collaboration that exists. The complex problems and “team approach” at Harborview provide an outstanding opportunity for interspecialty and interdepartmental collaboration in patient care, education, and research that goes to the core of Plastic Surgery as a discipline.

• The same collaborative model exists in the area of facial trauma, where Dr. Joseph Gruss brought his pioneering approaches to Harborview in 1990 and now, in collaboration with Otolaryngology, Oral Surgery and Ophthalmology, the craniofacial surgeons: Drs. Hopper, Gruss, Birgfeld and Tse, provide the best interdisciplinary facial trauma care in the world.

UW Medical Center

The Plastic Surgery Program at UWMC took off like a rocket with the arrival of Dr. Peter Neligan in July of 2007 as Chief of Plastic Surgery at UWMC. Dr. Neligan was the Chief of Plastic Surgery at the University of Toronto, the largest program in North America. As a world-renowned microsurgeon, he now leads the interdisciplinary/interdepartmental UW Medicine Center for Reconstructive Surgery that is a critical resource for all of the clinical services and programs at UWMC as well as the Seattle Cancer Care Alliance. The team at UWMC also includes Dr. Otway Louie, who joined us in 2008 after training at NYU with a microsurgery fellowship at UCLA; Dr. Hakim Said who joined us  in 2006 after training at Northwestern with a microsurgery fellowship at MD Anderson; and Dr. David Mathes, who also joined us in 2006 after training at UT Southwestern with a three-year research fellowship at Harvard.

This team has taken reconstructive microsurgery at UWMC to a new level, and they now have one of the busiest operative services at UWMC and are a critical resource for every other surgical service at that site. In addition, they have become a leading regional and national referral center for complex reconstructive surgery.

VA

The Plastic Surgery Program at the VA Hospital has also undergone tremendous expansion in both the clinical and educational program since Dr. David Mathes took over as Chief in 2007. It is my privilege to serve as his “junior” faculty there. Under Dr. Mathes’ leadership, we have developed a stellar, diverse clinical program that has transformed the care of complex plastic surgical problems at that institution, where the case volume has nearly doubled in the last decade. This assures that opportunities for resident education in Plastic Surgery are some of the best in the program.

Dr. Mathes also has a powerful research program in the area of composite tissue transplantation (e.g. hand and face transplantation) in collaboration with Dr. Rainer Storb at Fred Hutchinson Cancer Research Center. Dr. Mathes has successfully applied for numerous research grants and awards that have allowed him to be extremely productive academically and have provided excellent research opportunities for a number of our residents.

Seattle Children’s Hospital

The growth of Plastic Surgery at SCH continues to be phenomenal. The Plastic Surgery Program at Children’s continues to be an important local, regional, and national resource, with the highest volume craniofacial program in the nation. Dr. Richard Hopper became the Chief of Pediatric Plastic Surgery and Surgical Director of the Craniofacial Program at SCH in 2005, taking over from the indefatigable Dr. Joseph Gruss, who built the program from nothing in 1990 to its current position of national prominence. Dr. Hopper has been successful in maintaining and further enhancing the reputation of the SCH program at both the local and national levels. Clinical activity has grown to the point where now four full-time faculty are fully engaged: Dr. Hopper, Dr. Gruss (who remains as busy as ever), Dr. Craig Birgfeld, who joined the faculty in 2007 after training at the University of Pennsylvania then finishing a UW craniofacial fellowship; and our newest addition, Dr. Ray Tse, who joined us in 2009, trained at the University of Toronto, with a pediatric plastic surgery fellowship, and a hand fellowship at Stanford. He also brings brachial plexus reconstruction to our clinical and educational program. In addition, these four continue to staff the maxillofacial trauma service at Harborview.

Future of the Division

We are proud of the current state of the Division of Plastic Surgery and remain committed to making the UW Plastic Surgery Program the finest in the world, while continuing to play a key role in the clinical, educational, and research missions of Department of Surgery, the School of Medicine, and the region.