He started his staff appointment at Sunnybrook Health Science Centre in the late 1970’s with a focus on facial trauma and reconstruction after being influenced by Dr. Paul Tessier. In parallel with the work that Dr. Paul Manson was doing at Shock-Trauma Hospital in Baltimore, he established the basic tenants of craniomaxillofacial trauma repair with publication of key papers on the use of rigid fixation for facial fractures, the use of primary bone grafting, and the use of CT for facial fractures. He also was key in establishing the multi-disciplinary focus for skin cancer care at Sunnybrook Health Science Centre. In 1992, he departed for Seattle, Washington in 1991 where he refocused his efforts in creating the pediatric Craniofacial Unit at Seattle Children’s Hospital. He is currently Professor in the University of Washington and holds the Marlys C. Larson Endowed Chair in Pediatric Craniofacial Surgery. He is highly respected as a master class surgeon and teacher and is responsible for training a remarkable number of craniofacial surgeons around the world. His prowess for managing complex craniofacial reconstructions and tumor cases is remarkable.