TRAINING

David Ralph Millard, Jr. was born at Barnes Hospital, St. Louis, Missouri, June 4, 1919. He earned a gold palm Eagle Scout and graduated cum laude from the Asheville School for Boys, Asheville, North Carolina. He received his B.A. in 1941 from Yale University, where he majored in English and was on the varsity football and boxing teams. President Gerald Ford, a law student at Yale, was his football coach. He received his M.D. degree from Harvard Medical School in 1944 and interned in pediatric surgery at Boston Children's Hospital under William E. Ladd and Robert E. Gross from October 1, 1944 - July 30, 1945. Dr. Millard served in the U.S. Navy from 1945-1946 as a plastic surgeon and attained the rank of Lieutenant, junior grade. Following the War, Dr. Millard served as an assistant resident in general surgery under Barney Brooks at Vanderbilt University Hospital in Nashville, Tennessee from 1946-1947.

During 1948-1949, Dr. Millard was a trainee under Sir Harold Delf Gillies at Basingstoke, England with other surgeons from around the world. He made regular visits to Professor T. P. Kilner at Oxford, whom he credits with teaching him repair of the cleft palate, and to Sir Archibald McIndoe at Harley Street, London when Dr. Gillies was out of town. During this period, Dr. Millard formed life-long friendships with his mentors and colleagues, such as Jack Mustarde. Another close friend and frequent guest at his home over the years was Jacques Maliniac. Dr. Millard advocated and popularized the submental incision for lipectomy, which is now a standard part of the facelift. He described the nasolabial lipectomy, which has become one of the accepted techniques to correct this difficult problem. And he developed the island flap palate repair, which is indicated in older cleft palate patients.

After his postgraduate training abroad, Dr. Millard served as an assistant resident in plastic surgery in 1949 at Barnes Hospital, Washington University, St. Louis under James Barrett Brown, Louis T. Byars, and Frank McDowell. However, Dr. Millard did not always agree with the accepted standards of these masters of their day and left St. Louis before completing his training. From July 1 - December 30, 1950, Dr. Millard completed his training as a fellow in plastic surgery with Clair Straith at the Straith Clinic in Detroit. In 1951, Dr. Millard served as the first full-time senior resident in plastic surgery at Jefferson Davis Hospital in Houston, Texas under Sidney Baron Hardy, Thomas Dillon Cronin, Robert A. Wise, and Raymond O. Brauer and taught at the Baylor Medical School in Houston during the 1951/52 year.

1952-1965

In 1952, Dr. Millard returned to England to co-author The Principles and Art of Plastic Surgery with Sir Harold Gillies, published in 1957. In this two-volume work, Gillies and Millard "outlined 16 principles which not only applied to plastic surgery problems but had a basis in a more general way to a philosophy of life." Millard has been "guided in and out of the operating room" by the principles he and Gillies "fashioned together during 1952-1953 and published in 1957. … they are the result of personal lessons learned from both successes and failures, retained in memory and crystallized into proverbs of short sentences spawned from long experience." In 1996, Blair O. Rogers, editor of Aesthetic Plastic Surgery, wrote: "… there was almost nothing in the art of plastic surgery that had not been wonderfully and colorfully described in this two-volume masterpiece by Gillies and Millard."

Between 1951 and 1954, Dr. Millard was licensed to practice medicine in Florida (1951), Michigan (1951), North Carolina (1953) and California (1954). He became a member of the American Board of Plastic Surgery in 1954. Dr. Millard served in the Korean Conflict as Chief Plastic Surgeon to the U.S. Marine Corps from 1954-1955 and attained the rank of Major.

It was at a MASH unit in Korea that Dr. Millard performed the first rotation-advancement procedure for cleft lip repair. At age 35, Dr. Millard described the definitive technique for closure of the unilateral cleft lip at the 1st Congress of the International Society of Plastic Surgeons in Stockholm, 1955. Allocated a maximum of five minutes by Secretary Tord Skoog, Dr. Millard began his talk from the floor as he walked slowly to the podium. Long-time friend T.P. Kilner allowed Dr. Millard the flexibility necessary to complete this important presentation. For his reconstructive work on Korean children, Dr. Millard received letters of appreciation from the U. S. Marines and the Korean Marines and a letter of commendation from the Civil Affairs Section, First Marine Division, Republic of Korea in 1955. Major Millard was discharged September 15, 1955.

Dr. Millard started his career teaching at the University of Miami in 1956 and became a fellow of the American College of Surgeons in 1958. To continue his work on cleft lip repair, Dr. Millard made his first trip to the Kingston Public Hospital in Jamaica in 1959 and was named honorary consultant to the Government of Jamaica in 1960. In 1964, Dr. Millard developed the primary use of septal columellar strut, still a standard adjuvant in rhinoplasty. For his paper "Total Reconstructive Rhinoplasty and a Missing Link," he received first prize, Senior Division, 1965 International Scholastic Contest of the Education Foundation of the American Society of Plastic and Reconstructive Surgeons. Behind the then Iron Curtain in Bratislava, Czechoslovakia, Dr. Millard demonstrated the rotation-advancement cleft lip technique and, with Eric Peet, the Oxford palate technique and its lengthening with an island flap. He was given a medal by Komenius University, Bratislava in 1965 for "Contributions in the Field of Plastic Surgery."

1967-1974

In 1967, Dr. Millard was promoted to Clinical Professor and named Chief of the Division of Plastic Surgery at the School of Medicine. For his paper, "Free Skin Grafting of Full-Thickness Defects of Abdominal Wall," he again received first prize, Senior Division, of the 1968 International Scholastic Contest of the Education Foundation of the American Society of Plastic and Reconstructive Surgeons. The Education Foundation subsequently created the D. Ralph Millard Investigation Scholarship Award for the most outstanding research in the general plastic surgery which continues to be awarded annually. His popular tip ("shield") graft was developed in 1968 and continues to be one of Millard's most widely used rhinoplasty techniques. He served as associate editor of Plastic and Reconstructive Surgery from 1969-1975 and has been a member of the editorial board of Excerpta Medica: Plastic Surgery since 1970. In 1970-1972, Dr. Millard was elected President of the Educational Foundation of the American Society of Plastic and Reconstructive Surgeons.

During the 1960s and 1970s, Dr. Millard continued his pioneering work on cleft lip and palate and rhinoplasty throughout South Florida and the Caribbean. In addition to his appointment at Jackson Memorial Hospital, Dr. Millard is an attending surgeon at the U. S. Veteran's Administration Hospital, Miami; Mount Sinai Medical Center, Miami Beach; Children's Hospital, University College of West Indies, and Kingston Public Hospital, Jamaica; Charles A. Cannon, Jr. Memorial Hospital, Banner Elk, North Carolina; and Miami Children's Hospital where he was Chief of the Department of Plastic Surgery. Dr. Millard was a consultant in plastic surgery at the U.S. Naval Hospital in Key West and at the U.S. Veteran's Administration Hospital in Miami.

In 1971, Dr. Millard was invited to present the Gillies' Gold Medal Lecture at the Royal College of Surgeons, London. Presented by the elite Plastic Surgery Society, Dr. Millard is the only American ever to have received the Gillies Memorial Gold Medal. He participated in the International Congress on Cleft Lip and Palate in 1971 in Melbourne, Australia. In 1973, he was elected to the American Board of Plastic Surgery, moderated a Panel on Bilateral Cleft Lip at the Second International Congress on Cleft Lip and Palate in Copenhagen, and addressed the American College of Surgeons' 59th Clinical Congress on Plastic Surgery in Otolaryngology in Chicago.

Dr. Millard became the first Light-Millard Professor of Plastic Surgery in 1974, a position he holds to this day. He was also Chairman, South Florida Cleft Palate Clinic of the Mailman Center for Child Development at the University of Miami. He was named Visiting Professor of Surgery at Massachusetts General Hospital and Harvard Medical School and delivered the "Edward P. Richardson Lecture" at MGH on May 24, 1974. He was named Visiting Professor of Surgery at Yale University School of Medicine and addressed the New England Society of Plastic and Reconstructive Surgeons at Mystic Seaport, May 31 - June 1, 1974. He is an honorary member of the New England Society of Plastic and Reconstructive Surgeons, a charter member of the International Society of Aesthetic Plastic Surgeons of the International Confederation for Plastic and Reconstructive Surgery, and, since 1972, a corresponding member of the British Association of Plastic Surgeons. On October 28, 1974, the D. Ralph Millard, Jr., M.D. Plastic Surgery Society was formed.

1975-1981

Dr. Millard organized the Symposium on Corrective Rhinoplasty, sponsored by the University of Miami and held in Miami in 1975. This symposium included some of the greatest names in rhinoplasty, such as Joseph Safian and Gustave Aufricht who had been trained by Jacques Joseph. Dr. Millard edited the Proceedings of the Symposium, published in 1976.

In 1976, Dr. Millard's Cleft Craft: the Evolution of its Surgery: I.-The Unilateral Deformity was published. It received the 1976 R.R. Hawkins Award of the American Publishing Association for excellence in books in the category of medicine, technology, and science. It was reviewed by Time and nominated for a Pulitzer Prize. Volume I was followed by volume 2, Bilateral and Rare Deformities, published in 1977, and by volume 3, Alveolar and Palatal Deformities, published in 1980. Dr. Millard worked on this trilogy two hours each day, and 14 hours each weekend for twelve years. The three volumes, which continue as the definitive work on cleft lip and palate, maintained the excellent standards for pre- and post-operative photographs, illustrations, historical descriptions, and portraits of the pioneers in cleft palate surgery established in the two-volume The Principles and Art of Plastic Surgery. Together, these five volumes established Dr. Millard's reputation as one of the greatest authorities in the entire field of plastic surgery.

Following years of gratis surgery for children with cleft palate in Jamaica, Dr. Millard received the Order of Distinction Medal from the Government of Jamaica in 1976 from Premier Manley, an honor given only to individuals who perform unusual service for the Government. He received the First Annual Herbert Lipshutz Memorial Prize in 1976 for his paper "Breast Reconstruction Following Radical Mastectomy." Dr. Millard was the George H. Monks Lecturer in Surgery, sponsored by Harvard University, Peter Bent Bingham Hospital, and Children's Hospital Medical Center in Cambridge, Massachusetts in September, 1977. He addressed and performed surgery for the Cleft Lip and Palate Symposium at the University of Michigan in May, 1977. He was a guest lecturer at the American Cleft Palate Education Foundation's Symposium on Refinements in Cleft Lip and Palate Surgery at Northwestern University in March, 1977. He was an invited speaker at the 3rd International Congress on Cleft Palate in Toronto in June, 1977. He gave an invited presentation on "Breast Reconstruction Following Mastectomy" at the University of Miami's Surgery Postgraduate Seminary on Miami Beach in January, 1978. He gave an invited address at the Florida Cleft Palate Association 17th Annual Meeting and Postgraduate Course in Miami Beach in February, 1978.

A Director of the American Board of Plastic Surgery, Dr. Millard served as a delegate to the American Medical Association from 1973-1979 and was elected Vice-Chairman for April 28,1978 - April 25, 1979. He was a trustee of the American Association of Plastic Surgeons from 1979-1981. For his many contributions to surgery, Dr. Millard was given the <Asheville Award> in 1979, the highest honor of his alma mater, and the 1981 Honorary Award of the Association of Plastic Surgeons, the highest honor of this elite organization. For "Distinguished Contributions to Cleft Palate Habilitation," he was given the Florida Cleft Palate Honors Award in 1979. He was nominated and accepted to the Wisdom Hall of Fame of the Wisdom Society for the Advancement of Knowledge and Research in Education, Beverly Hills, California. He is a member of Men & Women of Distinction, Diploma of Distinction - Roll of Honour, of the International Biographical Centre, Cambridge, England.

Dr. Millard was awarded a U.S. patent in 1979 for his mouth gag with universal adjustability to the alveolar arch. He addressed the Symposium on Flaps and Grafts at the University of California, Los Angeles in February, 1979 on Rhinoplasty. He was an instructor on Reconstructive Surgery of the Breast for a postgraduate course at the University of Miami in January, 1980 and delivered a lecture on reconstructive rhinoplastry at the University of California, San Diego in March, 1980. His film, "The Management of Cleft Lip and Palate," was shown at the 1980 American College of Surgeons' Clinical Congress in Atlanta. He presented the Kazanjian Lecture at New York University in October, 1980. He gave a seminar on reconstruction following surgery for breast cancer in Bal Harbour in January, 1981 and was course director for the Symposium on Cleft Lip and Palate in Miami in March, 1981. He was named James Barrett Brown Visiting Professor in Plastic and Reconstructive Surgery at Barnes Hospital, St. Louis in April, 1981. Presented by the governor, Dr. Millard received the State of Indiana's highest award in 1981.

1982-1989

Dr. Millard was elected a senior fellow to the American Surgical Association in 1982 and served as Vice-President, President-elect, and President of the American Association of Plastic Surgeons from 1982/83-1984/85. He was named Visiting Professor, Indiana University Medical School in June, 1982 and Visiting Professor of Surgery, Johns Hopkins, November, 1984. He was a guest lecturer at the British Postgraduate Medical Federation's Advanced Course in Plastic Surgery, Skin Tumors and Facial Reconstruction at St. Johns College, Cambridge University, September, 1982. He delivered the opening address at the 8th International Congress of Plastic Surgery in Montreal, 1983. He received the AMA Physician's Recognition Award in 1984. In 1985 he received the Honors Award given by the American Cleft Palate Association and the Membership Award of the Reed O. Dingman Society. Dr. Millard is a consulting member of the Society of Head and Neck Surgeons and a member of the Dade County Medical Association, the Southern Medical Association, the American Cleft Palate Association, the Florida Association of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Society of Plastic and Reconstructive Surgeons, and the Canadian Society for Aesthetic Plastic Surgery.

In 1986, Dr. Millard published Principlization of Plastic Surgery, a successor to The Principles and Art of Plastic Surgery in which the original 16 principles were modified and expanded into 33. Like Cleft Craft, Principlization was also nominated for a Pulitzer Prize. The same year, Dr. Millard was given Honorary Fellowship by the Royal College of Surgeons, Edinburgh, was named Physician of the Year by the Dade County Medical Association, and was one of six winners, out of 500 contestants, of the Spirit of Excellence award of the Miami Herald. He was named Visiting Professor, University of Pennsylvania for the James Barrett Brown Society and was a guest lecturer for the Robert H. Ivy Society in Hershey, Pa. He was made an honorary member of the Tagliacozzi Society and delivered the Tagliacozzi Guest Lectureship at the University of Bologna, Italy in June, 1986. He was an invited lecturer at the Demonstration in Noses by Design display at the Smithsonian Institution from May - June, 1986. The Millard Children's Ward at City Hospital, Nottingham, England, was named in June, 1986.

In 1988, Dr. Millard received the highest award of the American Society of Plastic and Reconstructive Surgeons in recognition of "his development of the specialty of plastic surgery and his outstanding scientific contributions to the advancement of its practice." He received an Honorary Medal from the People's Republic of China for "his monumental achievements in cleft lip repair which has opened a new era of cleft lip surgery" and was guest lecturer at the Chinese Plastic Surgery Society, Beijing; the Fourth Military Medical College, Xi-An; and the First Military College, Canton, China. He was honored by President Onizuka and made an Honorary Member of the Japan Society of Plastic Surgery. He presented the Michel Gilbert memorial Lecture, "Progress in Pediatric Cleft Surgery," at Miami Children's Hospital. In 1989, Dr. Millard was given honorary membership in the British Association of Plastic Surgeons and named  Jerome Webster Visiting Professor, New York, N.Y.

1990-

Dr. Millard was made an Honorary Fellow of the Royal College of Surgeons, London in 1990. He received the Distinguished Faculty Scholar Award of the University of Miami and a bronze bust was placed in the Miami Children's Hospital Hall of Fame in 1991. In 1992, he received the Dieffenbach award at Humbolt University, Berlin, a special award given to 30 surgeons to commemorate the 200th anniversary of the birth of Johnson Frederich Dieffenbach. Among Dr. Millard's many trainees were two of Dr. Dieffenbach's descendents and Vladimir Mitz, who is credited with the definitive anatomical description of the SMAS structure. The same year, he delivered the first John M. Converse lecture and a photograph of members of the D. Ralph Millard Society was taken on the White House lawn.

In 1993, Dr. Millard received the Hunterian Professor award, given to members of the Royal College of Surgeons, England, following the Hunterian Lecture at the College at Oxford. Dr. Millard is the only American plastic surgeon to have received this medal, named for John Hunter, the father of modern surgery. And in 1996, the Daughters of the American Revolution bestowed the Medal of Honor on Dr. Millard.

Dr. Millard's most recent contribution to the teaching of plastic surgery is A Rhinoplasty Tetralogy published in 1996. In the preface, Dr. Millard writes: "This book is an attempt through personal experience over 50 years in the second half of the 20th Century to pick up where Joseph left off in the refinement of the craft of rhinoplasty. This is a series of noses that have been collected in their specific section to describe exactly how they have been treated surgically as a primary condition, as a secondary procedure, as a congenital anomaly, or as a reconstruction." The clear and beautiful artwork is to the credit of the artists, but also to the author. Dr. Millard "… enjoyed art classes in preparatory school and later took charcoal portrait sketching … at Washington University in St. Louis, while studying at Barnes Hospital, and a night course in sculpting at Wayne State University, while studying in Detroit." His four monographs are in addition to 202 articles published throughout his career.

Also in 1996, Dr. Millard was the guest speaker at the "Masters" Program of the New York Regional Society of Plastic and Reconstructive Surgery and the Section on Plastic and Reconstructive Surgery of the New York Academy of Medicine. In November, 1997, Dr. Millard gave the Ross H. Musgrave Lecture and performed two surgeries at the University of Pittsburgh. In December, 1997, he gave the 4th Biennial Ralph H. and Ruth F. Gross Lecture at the University of Miami in which he traced the many contributions to the field of plastic surgery that emanated from the School of Medicine from 1956-1996. The Gross Lecture was followed by a dedication of the D. Ralph Millard, M.D. collection, given to the Louis Calder Memorial Library and processed as a permanent archive in 1996-1997. It is this collection of portraits of the leaders in plastic surgery spanning the past three centuries, together with their books and Dr. Millard's many publications, awards, and commendations, that was digitized at the D. Ralph Millard, M.D. Plastic Surgery Photo Archive for the benefit of plastic surgeons throughout the world.

In 2000, Dr. Millard was nominated as one of only 10 "Plastic Surgeons of the Millennium" by the members of the American Society of Plastic Surgery. In the April 2000 issue of Plastic Surgery News, Dr. Millard is described as "the most brilliant and creative plastic surgeon we have alive. His work and publications speak for themselves." ASPS Past President Dr. Mark Gorney wrote in the April issue: "Ralph Millard, M.D., during my lifetime, is the living personification of what I have always tried to impart to all residents I have been privileged to teach; the only difference between an ordinary plastic surgeon and a truly extraordinary one is the degree of imagination he/she brings to the table." And, ASPS Past President Dr. Barry Brody wrote: "While he [Millard] made many contributions in many areas including nasal reconstruction and the "crane" principle, his nomination stems from his major development of improved techniques for repair of cleft lip and palate deformities."

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