David B. Powers1, Jin Ye Yeo2
1Duke Craniomaxillofacial Trauma Program, Duke Craniomaxillofacial Trauma and Reconstructive Surgery, Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC, USA; 2JOMA Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. JOMA Editorial Office, AME Publishing Company. Email: joma@amegroups.com.
This interview can be cited as: Powers DB, Yeo JY. Meeting the Editorial Board Member of JOMA: Dr. David B. Powers. J Oral Maxillofac Anesth. 2025. Available from: https://joma.amegroups.org/post/view/meeting-the-editorial-board-member-of-joma-dr-david-b-powers.
Expert introduction
Dr. David B. Powers (Figure 1) is currently a Professor of Surgery in the Department of Surgery, Division of Plastic, Maxillofacial and Oral Surgery at Duke University Medical Center. He holds a secondary appointment as a Professor of Surgery in the Department of Neurosurgery and the Department of Head and Neck Surgery & Communication Sciences. He additionally serves as Director of the Craniomaxillofacial Trauma Program, and Fellowship Director for the Craniomaxillofacial Trauma and Reconstructive Surgery Fellowship. He attended the University of Kentucky for his undergraduate and dental degrees, the University of Texas Health Science Center – San Antonio for his medical degree, and completed his General Surgery internship and Oral & Maxillofacial Surgery residency at Wilford Hall USAF Medical Center and San Antonio Military Medical Center in San Antonio, Texas. His surgical experience in facial trauma was attained during a 21-year military career highlighted by the acute management of ballistic and other injuries of warfare, as well as performing secondary and tertiary facial reconstructive surgery during various staff assignments at Wilford Hall USAF Medical Center, the National Naval Medical Center – Bethesda and the R Adams Cowley Shock Trauma Center in Baltimore, Maryland. He lectures and has published extensively on the management of ballistic and high-energy transfer injuries to the craniomaxillofacial skeleton, comprehensive reconstruction techniques for facial trauma, and the use of computer-aided surgical planning and patient-specific implants for anatomic rehabilitation after catastrophic craniomaxillofacial injuries.
Figure 1 Dr. David B. Powers
Interview
JOMA: What inspired you to pursue a career in surgery, particularly in the field of craniomaxillofacial and plastic surgery?
Dr. Powers: The motivation I had to pursue a career in craniomaxillofacial surgery ultimately was predicated upon my experiences in the military. I had always considered a career in surgery as I felt comfortable with complex problem solving and was fortunately blessed with supportive parents who nurtured my growth and intellectual curiosity as a child. My father’s hobby was woodworking, and I spent countless hours with him after work assisting him with projects, gaining invaluable skills associated with the visualization of solutions to geometric problems and the development of hand-eye coordination. This naturally led to pursuing a career where these attributes would be used daily, and through my parents, I received a strong foundation of service and sacrifice for the benefit of others.
JOMA: You have a distinguished military career spanning 21 years. How did your time in the military influence your approach to surgical practice and trauma management?
Dr. Powers: My experiences in the military have had a profound impact on both my outlook and provision of surgical care. When I first joined the military, the thought that my country would be involved in active, sustained combat operations for essentially the entirety of my career would have been unfathomable. After the attacks on the US homeland in September 2001, I knew that my country was going to war and brave young Soldiers, Sailors, Marines, Airmen, and innocent civilians would be harmed in the conflict. At that moment, I dedicated myself to learning all that I could regarding the management of ballistic trauma and facial reconstructive surgery. The face is a person’s gateway to interacting with society, and the loss of that portion of their body can result in horrific psychosocial depression, withdrawal from contact with peers and loved ones, as well as the loss of the simple pleasures of life such as laughing, eating, drinking, and carrying on intelligible conversation. After my military career, I carried these objectives with me to the private sector, and they continue to focus my attention and commitment daily. One of the greatest aspects of my career is that you meet people and their family on one of the worst days of their lives, and I am privileged to be able to assist them with both the acceptance of what has happened as well as feeling a sense of gratitude to be able to say “today I made a difference by being here”.
JOMA: You have published extensively on comprehensive reconstruction techniques for facial trauma. Could you share some of the emerging surgical techniques and technologies that you find most promising?
Dr. Powers: I believe we have made terrific strides during the course of my professional career in the areas of custom patient implants and bony reconstruction. Advances within the past year in these areas continue to impress me with the ability to accurately reconstruct the facial skeleton literally within millimeters of the contralateral side. These advances in hard tissue management are, unfortunately, not similar to our treatment of soft tissue defects. The current development of modulated tissue regeneration, including autologous skin, muscle, and bone, offers an almost unbelievable opportunity to reconstruct our patients with their own tissues – minimizing the potential of tissue rejection and affording a level of precision previously thought unattainable. There is little doubt in my mind that in the course of the professional lifetime of our current surgical trainees, reconstructive facial surgery will involve not only custom surgical hardware but also custom autologous soft and hard tissues.
JOMA: How have computer-aided surgical planning and the use of patient-specific implants transformed the way you approach surgical cases?
Dr. Powers: The concept of patient-specific implants changed how I practiced reconstructive surgery. The results attained on extremely challenging cases are highly accurate and near anatomic in nature. These implants are routinely used in the management of not only complex index surgical cases but also in the treatment of secondary and tertiary surgical corrections. To paraphrase my old mentor Paul Manson, “You never get a second chance to do a good primary reconstruction”.
JOMA: What aspects of facial trauma surgery do you believe have received insufficient attention?
Dr. Powers: As noted previously, the role of soft tissue management in the treatment of complex craniomaxillofacial trauma is currently underemphasized in primary management. Research is pushing this forward, but there is still plenty of work to do. Additionally, the role of intraoperative imaging in the field of craniomaxillofacial trauma is extensively underutilized. Our Orthopedic Surgery colleagues have consistently found a way to incorporate intraoperative radiology into all aspects of care – verifying reduction and stabilization of their fracture repairs. By historical preferences, many in the craniomaxillofacial trauma field this is not necessary, or should only be in an “as needed” basis. As someone who does a high volume of stock plate and patient-specific reconstructions, I can assure you that you can be fooled by the soft tissue and osseous alignment, resulting in the fracture reduction being placed in the wrong vector or position. Technological advances in fluoroscopy and portable imaging formats make radiographs easily accessible, even in remote locales. Incorporation of intraoperative imaging should become paramount to all craniomaxillofacial reconstructive procedures.
JOMA: What role does mentorship play in your career, and how do you support the next generation of surgeons in your field?
Dr. Powers: I have been fortunate to have an almost unlimited number of mentors, peers, and students – all who have provided me with opportunities to grow and develop as a surgeon, officer, leader, and man. Whether it was focusing on my surgical techniques or my continued growth as a surgeon, leader, husband, father, and friend, my mentors continue to serve me well to this day. As with any intellectually honest person, my perspectives have changed over the course of my career. Foundational bedrocks cannot, and should not change: pursuit of excellence in outcomes, treating all of your patients, colleagues and peers with honesty and humility, and to maintain the emotional curiosity of “why” … Why do we do this procedure, Why can’t we change that outcome, Why do we accept that is not possible. My experiences as an educator show me that if we impart the excitement we feel for our profession and the “why” to our next generation of surgeons, their motivation will also lift you emotionally to continue to strive to improve your practice and outcomes – whether they be professional or personal. There is a reason we are referred to as the medical and surgical community, and engagement with the entirety of the community is how we succeed as a profession.
JOMA: How has your experience been as an Editorial Board Member of JOMA?
Dr. Powers: I am always humbled to be associated with peers and colleagues who not only provide avenues for professional and intellectual growth, but serve as servant leaders highlighting these attributes in their personal lives. I am honored to have been considered worthy to join this Editorial Board and commit to continuing to provide guidance and positive influences to those that this position introduces me to.
JOMA: As an Editorial Board Member, what are your expectations for JOMA?
Dr. Powers: To provide the highest level of academic integrity in the presentation of scientific information that improves the lives and treatment outcomes for our patients.