I - CV Summary
Ricardo Horta is a Plastic and Reconstructive Surgeon working at Hospital São João – Porto (Portugal), and
he is also Professor in Faculty of Medicine, Porto University. Since 19th of March 2021, he is chief of
the department of Plastic and Reconstructive Surgery of São João University Hospital.
He got special training in microsurgery and reconstructive craniofacial surgery in the Department of Plastic and Reconstructive Surgery at Chang Gung Memorial Hospital in Taipei (Linkou) – Taiwan, Republic of China, and in Aesthetic Surgery at Clinica Planas in Barcelona - Spain, and UT Southwestern Medical Center - Dallas, Texas (U.S.A).
He developed a research project, included in his doctoral thesis (PhD) in the area of facial disfigurement: microsurgical reconstruction of large defects and facial transplantation (one of his areas of interest) in a partnership with the Faculty of Medicine of the University of Porto.
He has more than 100 scientific publications, the vast majority as first author, in indexed international journals (medline) with scientific referees, in all the specialty areas of intervention: reconstructive, aesthetics, microsurgery, hand surgery, maxillofacial surgery and burns. He had several articles cited in relevant journals. He described innovative techniques in flaps dissection, and new reconstructive and aesthetic surgical procedures.
He is regularly invited to review scientific papers published in international journals. He is a reviewer for the Journal of Reconstructive Microsurgery.
He was author of a book chapter related to traumatic hand surgery. He was author of a book about mandibular reconstruction in the context of osteonecrosis.
He is part of the editorial board of the Advances in Plastic and Reconstructive Surgery.
He presented more than 200 scientific papers in conferences; he was a speaker and moderator in national and international scientific meetings on several occasions.
He practices the concept of “total plastic surgery”. Within his surgical activity over the last few years in the public sector, he highlights several highly complex surgeries, involving teamwork with colleagues from Plastic Surgery, or in collaboration with other specialties (see section II). Having a solid and differentiated surgical background, he is able to deal with all kinds of situations or complications. In his private practice, he has intuition and interest in performing all types of cosmetic surgery, namely facial cosmetic surgery, breast surgery or body contouring.
II - Most outstanding surgeries/Technologies developed for Aesthetic and Reconstructive Surgery/Research projects
• He performed a worldwide pioneer ear reconstruction with prefabrication in the forearm, and microsurgical transfer after 3 months to the face.
• The same principles were used to develop a facial model on a patient's back with 60% total body surface area (% TBSA) burns, and posterior free transfer to the face for functional improvement of burns sequelae.
• He performed the first free Vascularized Lymph Node Transfer (VLNT) for physiologic lymphedema treatment at Centro Hospitalar São João (neck to the wrist transfer).
• Facial reanimation in a patient with concomitant facial paralysis and blindness. This controversial surgery, was the first to be described worldwide in a blind patient and involved the transplantation of gracilis muscle (thigh) to the face with vascular anastomosis and nerve coaptation; subsequently the patient started a rehabilitation program by acoustic and sensory feedback (touch) that allowed her to contract the transplanted muscle, optimizing facial symmetry, and improving her social and school interaction.
• Among the surgeries that most impressed and touched him, he highlights the reconstruction of the diaphragm in an orphaned 3-year-old child, who was born with almost total diaphragmatic agenesis. Due to the insufficient separation of the thoracic and abdominal cavities (absence of the diaphragm), this child had severe respiratory failure with dependence on mechanical ventilation and growth retardation due to herniation of the abdominal contents into the chest. For the reconstructive procedure, he transferred a tunneled latissimus dorsi muscle flap (from the back) between the ribs to an intrathoracic position, and the motor nerve was connected to a fascicle of the phrenic nerve (responsible for the contraction of the diaphragm), maintaining a remaining fascicle in continuity; this technique allowed, in addition to an effective separation of the chest and abdomen, the synchronic and non-paradoxical contraction of the diaphragm after 3 months. The child currently has a normal development and no longer depends on mechanical ventilation, and has been taken in by a foster family.
• Successful ear replantation after total amputation caused by human bite.
• Several replantation surgeries, for example, finger replantation with more than 20 hours of warm ischemia, or replantation of a forearm in a 10-year-old child.
• Orthotopic free tissue transfer (including tendons) from one forearm to the contralateral side, for reconstruction of a total forearm degloving injury.
• Many others surgeries could be highlighted namely for the reconstruction of major facial, body and upper / lower limb deformities. For instance, the case of face reconstruction in a female patient with history of oral cancer and severe disfigurement due to osteoradionecrosis, with multiple orocutaneous fistulas. In a first stage, a vascularized fibula transfer for mandible reconstruction was attempted. Due to the absence of bone consolidation and fistula persistence, all the tissue of the lower third of the face was removed and the defect was reconstructed with a chimeric ALT flap (2 different skin and muscle paddles at 90º) for extra and intraoral coverage, with interposition of a collagen dura mater membrane between the previous bone (fibula) and the flap. Such surgery successfully made it possible to solve all the patient's problems.
• He first described the adipofascial perforator flap for the dorsum of the foot in the clinical context, the perforator facial artery flap for intraoral reconstruction and the composite chondrocutaneous peninsular flap associated with a retroauricular flap for partial ear defects.
• Together with the Institute of Health Research and Innovation at the University of Porto (i3S) he developed new technologies for analyzing facial dymamic excursion such as the Facegram, and together with LABIOMEP thermography and avatars ere also developed.
• He developed a new anatomical cadaveric model for facial allotransplantation - study at the Institute of Legal Medicine of Porto and Department of Anatomy (FMUP).
• In the field of cosmetic surgery, he developed a new tool (ruler) for preoperative marking of abdominoplasty, together with iSurgical3D.
• He and his team developed and first described ultrasound guided fat transplantation (breast lipofilling or body remodeling with fat grafts).
• He described the preoperative use of Doppler for marking the perforator vessels in in breast reduction with superomedial or superolateral pedicles.
• He developed a new facial lifting technique (not yet published).
• Currently he has in partnership with 3Bs Research Group (Universidade do Minho) an innovative research project in the area of Tissue Engineering for tissue regeneration.
As Professor at the Faculty of Medicine- University of Porto (FMUP), he teaches medical students from the 4th to the 6th year in the Curricular Units of Surgery (clinical practice), Plastic Surgery and Orthopedics, and Wound Treatment (of which he is regent). He participates annually as supervisor or jury in several master's and doctoral thesis.