Plastic Surgery

The year 2020 was exciting for the Division of Plastic Surgery despite the Covid-19 pandemic. Lauren Schmidtberg, PA-C, joined the division full-time and has made a huge impact. The office administration and staff have been reorganized, allowing the division to provide a more robust service line. Monique France, RN, has advanced to practice/nurse manager for Plastic Surgery/Craniofacial Team and Neurosurgery, and Jennifer Euen, RN, has taken over as clinical care coordinator of the Division of Plastic Surgery/Craniofacial Team. Clinical services have been expanded and new clinical pathways developed. Education is a priority of the division, and three of our trainees were accepted into plastic surgery residency programs and a large medical student Plastic Surgery interest group has been established.

The Plastic Surgery division provides clinical services at Connecticut Children’s and at Hartford Hospital. Except for shutdowns related to the Covid-19 pandemic, our surgical volume has remained stable, and includes all types of plastic and reconstructive procedures. Our plastic surgeons frequently collaborate with other surgical specialists, providing state-of-theart multidisciplinary surgical care. Common surgical procedures performed include complex wound closures including flaps and grafts, craniofacial reconstruction, craniofacial fracture repair, cleft lip/ palate reconstruction, breast surgery/reconstruction, body contouring, skin/soft tissue tumor excision/repair, upper extremity/hand surgery/reconstruction, and cosmetic surgery/non-surgical cosmetic procedures. We have successfully implemented telehealth visits for consults and follow-up visits whenever necessary and appropriate.

Ms. Schmidtberg, a physician’s assistant with extensive plastic and craniofacial experience, joined the division in January 2020, and she has helped to expand the services provided. The division has increased and streamlined the treatment of breast and chest wall deformities, as well as post-bariatric-surgery weight loss deformities. Ear molding for infants with protruding

or malformed ears is now offered. The division is also actively participating in the Vascular Malformations Team. The office administration and staff have been reorganized and expanded to support the new clinical services. The reorganization of the administration and staff has been crucial to expanding clinical services.

The multidisciplinary Craniofacial Team at Connecticut Children’s, directed by division chief of Plastic Surgery Charles Castiglione, MD, MBA, remains a center of excellence. The team provides comprehensive evaluation and treatment for patients of all ages with congenital or acquired deformities of the head and neck. Active team members come from many disciplines including Plastic Surgery, Pediatric Neurosurgery, Pediatric Otolaryngology, Pediatric Dentistry, Orthodontics, Oral and Maxillofacial Surgery, Pediatric Development, Social Work, and Speech and Language Pathology. Clinical pathways for cleft lip and palate patients have been updated and modified with excellent results. Surgeries for these conditions are most common. Craniosynostosis reconstruction, performed by Dr. Castiglione and Christopher Hughes, MD, MPH, and by Jonathan Martin, MD, Markus Bookland, MD, and David Hersh, MD, of Pediatric Neurosurgery, are also common. Virtual surgical planning for cranial reconstruction and for mandibular distraction is now routine. In addition, the multidisciplinary Craniofacial Trauma Team, under the leadership of Drs. Castiglione and Norman Cavanagh, provides cutting-edge treatment for all craniomaxillofacial injuries at both Connecticut Children’s and Hartford Hospital.

Four plastic surgeons, Duff Ashmead, MD, Alan Babigian, MD, David Bass, MD, and Steven Smith, MD, are fellowship-trained hand surgeons, and they perform all types of upper extremity and hand surgery. This includes trauma surgery, and reconstruction for acquired and congenital deformities. These surgeons also provide coverage for hand call at Hartford Hospital and Connecticut Children’s.

Plastic surgeons are involved in volunteer activities, including surgical mission trips. Unfortunately, all mission trips in 2020 and 2021 have been canceled due to the Covid-19 pandemic. Dr. Babigian is director and Dr. Hughes is an active member of Hartford Hospital’s Global Health program.

Education is a large component of our division’s activities. Residents from General Surgery, Orthopaedic Surgery, Urology, Otolaryngology, Oral and Maxillofacial Surgery, and Emergency Medicine rotate on the service. Medical students also elect rotations on Plastic Surgery, and a large Plastic Surgery interest group has been created. Active teaching occurs during daily patient rounds, in the clinic/office setting, the emergency room, the operating room, and during planned teaching conferences. Several residents and medical students have expressed interest in a career in plastic surgery, and three residents were matched at premier plastic surgery residency programs in the past year. This brings to 59 the number of our residents and students who have moved on to plastic surgery since 1988 when Dr. Castiglione first began practice. Several residents and medical students are involved in research projects with Drs. Babigian, Hughes and Castiglione. In addition to publishing, Drs. Babigian, Hughes and Castiglione have presented papers locally and regionally. Presentations focused on the management of complex upper extremity trauma, the use of small mobile operating room spaces for surgical mission trips, and analysis of global health initiatives. Dr. Castiglione is the plastic surgery editor for Connecticut Medicine: The Journal of the Connecticut State Medical Society, and a reviewer for three journals: the American Journal of Cosmetic Surgery, Craniomaxillofacial Trauma & Reconstruction, and the Journal of Oral and Maxillofacial Surgery. Some department members are involved in local, regional and national professional societies. Dr. Babigian and Orlando Delucia, MD, are members of the executive council of the Connecticut Society of Plastic and Reconstructive Surgeons. Drs. Babigian and Castiglione are members of the executive council of the New England Society of Plastic and Reconstructive Surgery. Dr. Babigian is an active member of the Northeast Region Covid-19 Coalition Workgroup for Plastic Surgery.

PUBLICATIONS

Meara JG, Hughes CD, Sanchez K, Catallozzi L, Clark R, Kummer A. Optimal Outcomes Reporting (OOR): a new value-based metric for outcome reporting following cleft palate repair. Cleft Palate Craniofac J. 2021 Jan; 58(1):19-24. doi: 10.1177/1055665620931708. Epub 2020 Jun 18.

STAFF

Charles L. Castiglione, MD, MBA, FACS, Division Chief Brian Allen, MD Duffield Ashmead, MD Alan Babigian, MD David Bass, MD Alex Cech, MD Orlando Delucia, MD Christopher Hughes, MD, MPH Steven Smith, MD

Lauren Schmidtberg, PA-C Mindi Cieck, APRN M. Eileen Auclair, PA-C Paul C. Polzella, PA-C

CENTERS