Introduction
Ernesto J. Ruas, MD, FACS, is a prominent American plastic surgeon recognized for his contributions to reconstructive microsurgery, craniofacial surgery, and surgical education. Born in 1965, Dr. Ruas completed his undergraduate studies at the University of Michigan before earning his medical degree from the University of Illinois College of Medicine. After residency and fellowship training at the University of California, Los Angeles (UCLA) and the University of Southern California (USC), he established a private practice in San Diego, California, and serves as a clinical professor at the University of California, San Diego (UCSD). His work in the field has led to numerous peer‑reviewed publications, presentations at international conferences, and the development of new surgical techniques. Dr. Ruas is also actively involved in medical societies, serving on committees and holding leadership positions within the American Society of Plastic Surgeons (ASPS) and the American Society for Reconstructive Microsurgery (ASRM).
Early Life and Education
Family Background
Ernesto J. Ruas was born on March 12, 1965, in Portland, Oregon, to a Portuguese immigrant family. His parents, Maria and Jose Ruas, were both educators who emphasized the importance of academic achievement and community service. Growing up in a bilingual household, Dr. Ruas developed a strong affinity for both English and Portuguese, a skill that later facilitated his communication with diverse patient populations and colleagues worldwide.
Undergraduate Studies
Dr. Ruas attended the University of Michigan, where he pursued a Bachelor of Science degree in Biochemistry. During his undergraduate years, he participated in research projects focused on enzyme kinetics and participated in the university’s pre‑medical program. His senior thesis on the regulation of glycolytic enzymes earned departmental recognition, and he graduated with honors in 1987.
Medical Training
Medical School
From 1987 to 1991, Dr. Ruas attended the University of Illinois College of Medicine, where he earned his Doctor of Medicine degree. His curriculum included rigorous coursework in anatomy, physiology, pharmacology, and clinical rotations across internal medicine, surgery, and obstetrics‑gynecology. Notably, his clinical rotation in the Department of Plastic and Reconstructive Surgery sparked a lifelong interest in microsurgical techniques and congenital anomaly correction.
Residency
Dr. Ruas completed a general surgery residency at the UCLA Medical Center between 1991 and 1994. The residency program emphasized trauma care, abdominal surgery, and surgical research. During this period, he performed his first microsurgical procedures under the supervision of Dr. Charles B. Brumfield, a pioneer in free tissue transfer.
Fellowship
Seeking specialization, Dr. Ruas pursued a fellowship in Plastic and Reconstructive Surgery at the USC Keck School of Medicine from 1994 to 1997. His fellowship focused on craniofacial surgery, hand surgery, and microsurgery. Dr. Ruas’s fellowship research project on optimizing free flap viability in patients with comorbidities received the fellowship’s research award. He also contributed to the development of a new protocol for postoperative flap monitoring that has since been adopted by several institutions.
Clinical Career
Private Practice and Academic Appointment
In 1997, Dr. Ruas opened a private practice in San Diego, specializing in reconstructive plastic surgery. His clinic quickly gained a reputation for innovative approaches to craniofacial reconstruction, burn repair, and congenital deformity correction. In 2001, he accepted an adjunct clinical professor position at the UCSD School of Medicine, where he teaches surgical residents and fellows in reconstructive procedures, microsurgery, and patient care management.
Major Surgical Contributions
Over the course of his career, Dr. Ruas has performed more than 1,500 free flap surgeries, including radial forearm, anterolateral thigh, and latissimus dorsi flaps. He is credited with pioneering a modified "beveling technique" for radial forearm free flaps that reduces donor site morbidity while preserving vascular integrity. His work in craniofacial surgery includes the reconstruction of complex midface defects following tumor resection, utilizing a combination of tissue expansion and free flap transfer.
Burn Care
Dr. Ruas has also specialized in burn care, particularly in pediatric populations. He established a multidisciplinary burn unit at the UCSD Burn Center, collaborating with burn nurses, physical therapists, psychologists, and social workers. His research on early excision and grafting in pediatric burn patients demonstrated improved graft take rates and decreased scarring.
Research Contributions
Microsurgical Innovation
Dr. Ruas’s research has focused on enhancing microsurgical outcomes. In 2004, he published a paper on the use of intraoperative indocyanine green angiography to assess flap perfusion, which led to reduced flap failure rates in his practice. He has also explored the use of bioengineered vascular grafts to bridge small vessel gaps in free flap surgeries.
Contributions to Craniofacial Surgery
His work on craniofacial growth patterns has informed the timing of corrective surgeries in children with craniosynostosis. A 2008 study described the application of computer-aided surgical planning to optimize cranial vault remodeling, a technique now widely used in craniofacial centers.
Publication Record
Dr. Ruas has authored or co‑authored more than 70 peer‑reviewed journal articles and 12 book chapters. His most cited works include a review of free flap survival in patients with diabetes and a randomized controlled trial on the effectiveness of postoperative physiotherapy in improving functional outcomes after hand reconstruction.
Grants and Funding
He has received several research grants, including a National Institutes of Health (NIH) Small Business Innovation Research award for the development of a microvascular monitoring device. His grant work has facilitated collaborations with biomedical engineers and led to the commercialization of a low‑cost perfusion assessment tool.
Professional Service
Society Leadership
Dr. Ruas has served on the board of directors for the American Society of Plastic Surgeons (ASPS) from 2010 to 2014, chairing the Education Committee during his tenure. In 2015, he was elected as the national president of the American Society for Reconstructive Microsurgery (ASRM), a role that involved advocating for standardized training curricula and promoting international collaboration.
Educational Outreach
Committed to surgical education, Dr. Ruas has developed curriculum modules on microsurgical techniques for residency programs across the United States. He also conducts annual workshops on craniofacial reconstruction for surgeons in developing countries, focusing on low‑resource settings.
Committee Involvement
His service includes membership on the ASPS Ethics Committee, the Plastic Surgery Foundation Board of Directors, and the National Board of Medical Examiners’ Plastic Surgery Examination Committee. Through these roles, he has contributed to the development of ethical guidelines for reconstructive procedures and the standardization of board examinations.
Awards and Honors
Dr. Ruas’s achievements have been recognized by multiple professional organizations. In 2002, he received the UCLA Alumni Association Distinguished Alumni Award for Medical Innovation. The American Society of Plastic Surgeons awarded him the Distinguished Service Award in 2011, honoring his contributions to education and patient care. In 2018, the International Society for Reconstructive Microsurgery honored him with the Lifetime Achievement Award for his extensive research and global outreach. Additionally, he was named a Fellow of the American College of Surgeons in 2019 and a Fellow of the American Society of Plastic Surgeons (FACS) in 2020.
Publications and Media
Selected Peer‑Reviewed Articles
- Ruas, E.J., et al. (2004). "Intraoperative Indocyanine Green Angiography in Free Flap Monitoring." Journal of Plastic Surgery, 58(3): 205‑212.
- Ruas, E.J., & Lee, S.H. (2008). "Computer‑Aided Cranial Vault Remodeling." Craniofacial Surgery, 22(4): 315‑321.
- Ruas, E.J., et al. (2010). "Early Excision and Grafting in Pediatric Burn Patients." Burns, 36(5): 612‑618.
- Ruas, E.J. (2014). "Microvascular Monitoring Devices: A Review of Current Technologies." Microsurgery Today, 3(1): 11‑18.
- Ruas, E.J., & Patel, M.K. (2019). "Rehabilitation Protocols Post Hand Reconstruction." Hand Surgery, 24(2): 89‑95.
Book Chapters
- Ruas, E.J. (2012). "Free Flap Techniques for Facial Reconstruction." In: Principles of Reconstructive Surgery (3rd ed.). Elsevier.
- Ruas, E.J. (2015). "Microsurgery in Low‑Resource Settings." In: Global Surgery Handbook. Springer.
Media Appearances
Dr. Ruas has appeared in several documentary series focused on surgical innovation, including a 2016 feature on the National Geographic channel discussing craniofacial reconstruction. He has also been a frequent contributor to medical news outlets, providing expert commentary on advances in microsurgery and plastic surgery techniques.
Personal Life
Dr. Ruas resides in San Diego with his spouse, Dr. Maria T. Ruas, a renowned otolaryngologist. The couple has two children, both of whom pursued careers in biomedical engineering. Outside of his professional commitments, Dr. Ruas is an avid sailor and volunteers with a local organization that provides free medical care to underserved communities.
Legacy and Impact
Ernesto J. Ruas has left a lasting imprint on the fields of plastic and reconstructive surgery. His innovations in microsurgical monitoring, craniofacial reconstruction, and burn care have been widely adopted by surgeons worldwide. Through his educational initiatives, he has mentored numerous residents and fellows, many of whom have gone on to become leaders in the field. His leadership within professional societies has helped shape training standards, ethical guidelines, and global collaboration, ensuring that the principles of high‑quality reconstructive care remain central to modern surgical practice.
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