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Making History

Dr. D. Ralph Millard, Jr.: Pioneer in cleft palate surgery and rhinoplasty left a lasting legacy

The movie and the TV series M*A*S*H (Mobile Army Surgical Hospital) were a big hit a couple of decades ago, but not many people know that it was during his service in just such a M*A*S*H unit in Korea that Dr. D. Ralph Millard, Jr. pioneered his groundbreaking cosmetic surgical techniques to treat the disfiguring effects of what is commonly referred to as cleft palate.
Millard, who died last year at age 92, was as much a Renaissance man as the 20th century could produce. Born in 1919, he was a force to be reckoned with even in his youth. In his early years, he became a Gold Palm Eagle Scout and graduated cum laude from the prestigious Asheville School for Boys in Asheville, N.C. While at prep school, he was on the varsity football and boxing teams, coached by none other than future president Gerald R. Ford.

Millard received his M.D. from Harvard Medical School in 1944 and interned in pediatric surgery at Boston Children’s Hospital, later training in cleft palate repair under prominent British physician Sir Harold Gillies and others in England.

He served as a plastic surgeon in the U.S. Navy from 1945 to 1946 with the rank of lieutenant junior grade, then went on to a number of other positions, including assistant resident in plastic surgery at Barnes Hospital at Washington University in St. Louis, Mo.

By age 35, Millard had achieved the rank of major and the title of Chief Plastic Surgeon to the U.S. Marine Corps. During his service in the Korean conflict in 1954-55, Millard performed a “rotational advancement” procedure to treat cleft palate. This was a technique for closing the lateral cleft lip. The revolutionary method utilized tissue from the “cupid’s bow” of the lip, which had often been discarded in standard repair procedures used at that time. Millard’s procedure was described as “definitive” and is adhered to even today.

Previously, surgery to correct cleft palates was postponed until patients reached their teens. The technique Millard developed allowed doctors to operate on children as young as 4 or 5 years of age, resulting in a mouth that was more natural looking and cutting time off the surgery.  Millard used his technique to benefit children both at home and abroad, charging a minimal fee or nothing at all.
In order to share his skills and knowledge, Millard began teaching at the University of Miami in 1956, becoming a fellow of the American College of Surgeons. He took his work in cleft palate repair to Jamaica in 1960. Later in his career, while still in the Caribbean, Millard addressed the topic of rhinoplasty surgery, developing the use of the septal columellar strut, another standard-setting procedure.

In addition to his surgical innovations, Millard was a writer and scholar. His 1957 two-volume publication, The Principles and Art of Plastic Surgery, which he co-authored with Gillies, is considered to be seminal in the art and science of plastic surgery.

During his long, illustrious career, Millard served for 28 years as head of the plastic surgery divisions of the University of Miami’s Miller School of Medicine and Jackson Memorial Hospital. He garnered honors and accolades too numerous to mention. The April 2000 issue of “Plastic Surgery News” described him as “the most brilliant and creative plastic surgeon we have alive.”

By Frank Kourt, Staff Writer
About the Author: Frank Kourt is a semi-retired communications professional. In addition to KY Doc, his work is featured regularly in The Richmond Register and the Madison County Advertiser, and he is a contributing writer for Living Well 50-Plus.



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