Harry J. Buncke, MD

The "Founding Father of Microsurgery"

The transition from Irquois Falls in Ontario, Canada, where he was born, to a world-renowned leader in microsurgery has been a remarkable journey for SMCMA’s 2006 Distinguished Award recipient Harry J. Buncke, M.D.

After a pause in his education for submarine duty in WWII aboard the U.S.S. Spadefish, Harry Buncke attended medical school at New York Medical College in a slightly unique fashion.

Harry J. Buncke, M.D.

While his submarine was being decommissioned at Mare Island, he met his bride to be, Constance Millette Buncke, who was visiting her sister in Vallejo. Her brother-in-law happened to be a general practitioner, and his lifestyle seemed so fulfilling that Harry Buncke decided medical school was a wise choice for him. Constance agreed, not only for this handsome naval officer, but for herself as well. The Bunckes were married before they started medical school. "We were in the same class and even shared the same cadavers. It was unusual to be sure," Dr. Buncke agreed.

Both Bunckes chose specialties: Harry Buncke, plastic surgery, "As soon as I dissected cadavers I was hooked," and Constance Buncke, dermatology, "She is a highly skilled dermatologist; one of the best."

Perhaps the pioneering spirit of his parents, who had moved so far from their home in the United States to a remote Canadian village, was imparted to Dr. Buncke as he made his life choices. Certainly his fellowship at the Royal Infirmary in Glasgow, Scotland, where he met teacher and researcher Dr. Thomas Gibson, also a plastic surgeon, profoundly changed his thinking. Dr. Gibson predicted the future of plastic surgery lay in microsurgery. "He first stimulated my interest in the possibility of tissue transplantation by vascular repair," Dr. Buncke explained.

After they finished training, the Bunckes toured the West Coast from bottom to top, stopping in Woodside to visit a friend from medical school, Dr. Richard Gonzales. Dr. Gonzales offered Dr. Buncke a partnership, and they opened an office in San Mateo in 1959. Dr. Constance Buncke’s office was in the same complex. In those days the Bayshore Highway was known as the "Bloody Bayshore," and the young doctors were busy treating victims of serious auto accidents almost daily, along with general plastic surgery. They saw firsthand the need for microsurgery, which was then a futuristic concept. If a patient’s finger was cut off in an accident, the digit was just discarded.

Dr. Buncke had to teach himself to perform these minute operations. There were no instruments to use; he had to fabricate his own. He crafted needles 75 microns in diameter, about the size of a human hair, from tiny pieces of stainless steel, drilling the holes under a microscope with a jeweler’s tool turned by hand. For sutures he first used silk thread from a silkworm cocoon, then unwound nylon thread using each tiny strand for suture material about 1/10 mm. Special double microscopes were designed to facilitate the work. The blood vessels to be repaired were one millimeter in diameter, the width of a paper clip. Each vessel was sewn with eight to 10 sutures under the special microscope. "Microsurgical replantation is one of the biggest advances in plastic surgery, and really all surgery, in the history of surgery. These instruments were the major breakthrough that made microsurgery possible, and I consider their development one of my greatest contributions to the field," Dr. Buncke said. "Now we can take young people and in two weeks time with all the modern equipment they can do what we took days and months to do before we had the equipment."

Experiments were continuing and in 1964 Dr. Buncke, assisted by Dr. Constance Buncke, performed his first successful rabbit ear replantation and the first toe-to-thumb transplant on the rhesus monkey.

In 1970 the Davies Medical Center in San Francisco invited Dr. Buncke to open the first microsurgery replantation service in the western United States. At that time George Monardo was president of the Medical Center, and he supported the research laboratory and the fellowship program. That led in 1972 to the first successful toe-to-thumb transplant in the United States. Other firsts followed: scalp replant, four-digit replant, multiple microsvascular simultaneous transplant, and others. "At first, we’d get one or two surgeries a month; now we have four to six big cases a week. These surgeries are extremely complicated. Without the help of the Monardos, first George and then his son Greg, we would not have been able to advance the field of microsurgery to the extent that we have," Dr. Buncke explained. The Davies Medical Center was renamed the California Pacific Medical Center, Davies in 1998 when it became part of Sutter Health.

Generous to a fault, Dr. Buncke has helped start microsurgery services besides his own at the University of California-San Francisco; Oak Knoll Naval Hospital; Stanford University; Royal Medical Center, Amman, Jordan; and the Hospital Jeanne d’Arc, Nancy, France. Through the fellowship program at the clinic, Dr. Buncke and his colleagues have trained more than a hundred surgeons, many of whom have gone on to establish microsurgery training programs and clinics of their own around the world following the Buncke Clinic model. "We’re putting ourselves out of business," Dr. Buncke joked. Their clinical research has produced about 500 papers on their analyses and findings.

In 1991 Dr. Buncke, with contributions from other writers, authored a book that had been 14 years in the making, Microsurgery: Transplantation-Replantation. It is considered the cornerstone text for the field of microsurgery and subsequently has been reproduced on the Buncke Web site by the Buncke Microsurgery Foundation.

In support of his profession, Dr. Buncke has served as president of the American Society for Surgery of the Hand and the American Association of Plastic Surgeons, served as chair of the International Society of Reconstructive Microsurgery and director of the American Board of Plastic Surgery. He was named one of the Top 10 Plastic Surgeons of the 20th Century and Clinician of the Year in 1989 by the American Society of Plastic Surgeons, Professor Honoris Causae by the French Ministry of Education, and is one of an elite group of hand surgeons who have been named Pioneers in Hand Surgery by the International Society for Surgery of the Hand. The California Pacific Medical Center funds an annual lectureship in Dr. Buncke’s name as part of the American Society of Reconstructive Microsurgery.

The Bunckes have four children, three of whom are physicians. Asked how they managed two busy medical practices with a large family, Dr. Buncke admitted, "Constance raised the children; she is a wonderful manager; she did a great job and they all turned out beautifully." Gregory Buncke, M.D., is a plastic surgeon, hand surgeon, and microsurgeon. When his dad retired two years ago, he took over as director of the Buncke Clinic. In his spare time Greg leads the jazz band his brother Geoffrey started in grade school; they still play around town and for friends. Geoffrey Buncke, M.D., is a hand surgeon, plastic surgeon, and microsurgeon in Portland, Oregon; Adele Buncke, M.D., practices industrial medicine in San Mateo, with a subspecialty in laser dermatology. Paul Buncke picked up some genes from his grandfather Buncke who was a gifted athlete. Paul is an expert ski instructor and real estate agent and builder in North Tahoe City.

Dr. Harry Buncke says he’s still dabbling in research even though he’s retired; he misses the patient contact and the excitement of being a part of cutting-edge medicine. As for travel, he had this to say: