Division 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.

Photo taken at the first meeting of the ABPS in Galveston, Texas, in 1938.*

At an AAPS meeting in 1937, Blair proposed the development of a plastic surgery board that would oversee plastic surgery residency training and set faculty qualifications. He met with other leading plastic surgeons and surgeons to set down bylaws and form the creation of the American Board of Plastic Surgery. Originally, the board was under the American Board of Surgery, but in 1941, it gained status as an independent specialty board At Washington University, one of Blair’s brightest pupils was Dr. James Barrett Brown, who became surgeon-in-chief of Plastic and Reconstructive Surgery 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.

James Barrett Brown treats a soldier during World War II.*

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. Brown succeeded Blair as chief of the Division in 1955. 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

Famous Blair Trainees*

Famous Blair Trainees

Brown’s Trainees*

James Barrett Brown in the operating room.

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. In the residency program, the faculty continues to offer complete, in-depth, lecture and textbook instruction as well as extensive clinical experience. As an academic institution, the division provides not only leading treatment but also an academically oriented, integrated residency-training program in plastic and reconstructive surgery and fellowship opportunities for advanced training. The program is continuously evaluated and updated to provide the most advanced training that prepares residents and fellows to be leaders in their respective specialties. Washington University plastic surgeons are also leaders in research with current studies in traumatic nerve injury; oncologic implications of fat grafting; outcomes of various types of breast reconstructions; limb transplant immunology; surgical outcomes in hand surgery; craniofacial reconstruction and developmental changes in the face; and peripheral nerve regeneration. Surgeons within the division are also focused on surgical education and integrating technology with education.

Division Chiefs

Justin M. Sacks, MD, 2020 – present
Susan E. Mackinnon, MD, 1996 – 2020
Paul M. Weeks, MD, 1970 – 1996
John E. “Jack” Hoopes, MD, 1968 – 1970
James Barrett Brown, MD, 1955 – 1968
Vilray P. Blair, MD, 1925 – 1955

*Photos and tables from Stelnicki EJ, Young VL, Francel T, Randall P. Vilray P. Blair, his surgical descendants, and their roles in plastic surgical development. Plast Reconstr Surg. 1999 Jun;103(7):1990-2009. The article is also a main source of information for this history.