There was a degree of incongruity in two awards that Wilmer’s Nick Mahoney, M.D., received in 2019 from the same organization. He was lauded with both a career achievement award and a Rising Star Award from the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).
“It’s a bit ironic. I’m only 38 years old, hardly at the beginning or the end of my career,” Mahoney says with a laugh.
His specialization is oculoplastic surgery— plastic surgery in and around the eye. It’s a subspecialty that arose out of the battlefields of World War II, when soldiers needed surgeries to repair wounds to the tissues surrounding their eyes. Today, an oculoplastic surgeon is more likely to see a recovering cancer patient than a war-wounded veteran, but the need is the same.
Mahoney scored his ironic double recognition in part because he has brought fresh thinking to ophthalmology with various computer-assisted learning tools. One key tool is the website learn.wilmer.jhu.edu, a comprehensive collection of ophthalmic training materials, including videotaped lectures, text-based materials, tests and quizzes. It’s a resource that he implemented and currently manages that allows Wilmer faculty members, trainees and medical students to self-pace their learning and revisit materials as time allows.
“I love to teach,” Mahoney says. “Wherever I’ve been in my career — resident, fellow, faculty member — it always seems I’m teaching those at the stage of their careers that I just completed.”
His facility for teaching is quickly gaining recognition. Mahoney has won awards for excellence in teaching three times since first coming to the Johns Hopkins University School of Medicine in 2010 to complete a fellowship. He is also author of more than 30 chapters in leading medical textbooks and of numerous peer-reviewed research articles. Recently, he received an Outstanding Contribution Award from ASOPRS for his role in creating a 50-year retrospective on achievements in oculoplastic surgery— for which he recorded interviews with 50 oculoplastic surgeons. And in 2020, he achieved a key milestone in an academic medical career: promotion from assistant to associate professor.
Mahoney has also tapped into the power of technology to advance his subspecialty, oculoplastic surgery. He uses computer-assisted surgical techniques, and he has published multiple protocols for designing virtual surgical implants and analyzing volumetric outcomes after surgery.
He has also developed an iOS app that allows an oculoplastic surgeon-in-training to learn how to optimally resect wounds near the eye. He calls the app FlapCon and explains that — among other things — it allows plastic surgeons to plan ways to close wounds by manipulating geometric shapes. Mahoney has won recognition from the ASOPRS and the American College of Mohs Surgery for his work on FlapCon.
Some of the programming for FlapCon was done with funding assistance from a Johns Hopkins Discovery Award grant; he’s even done some of the programming himself. When Mahoney considered potential future directions for expanding FlapCon, he saw an opportunity to partner with the Biomedical Engineering Design Team program at the Johns Hopkins Whiting School of Engineering.
The program brings together design teams to partner with faculty members throughout the university who have the vision to imagine new tools that solve engineering challenges but who lack the technical skill, product design experience or time to turn their novel idea into a powerful tool.
Mahoney guided a team of undergraduate engineering students in the work, along with faculty member Nicholas Durr, Ph.D., co-director of the undergraduate Design Team program and assistant professor in the Department of Biomedical Engineering.
Mahoney says the student team he collaborated with exceeded expectations. What began as a simple tool to better plan wound closures now includes algorithms that estimate skin tension, mechanical stress in the muscle and connective tissue, and how blood flow will be restored to the tissue.
“Each of these physiological dimensions leads to more seamless surgeries,” Mahoney says.
As an example, he points out that future directions of FlapCon will help surgeons avoid an adverse outcome known as an ectropion, in which all or part of the eyelid turns outward, leaving the eyelid’s inner surface exposed. FlapCon proactively alerts the user to problematic reconstructions.
It sort of says, ‘Hey, this suture is creating stress. That could be dangerous,’” he explains of FlapCon.
All of this work takes time and money to develop. Mahoney says he could not achieve so much without the financial support he has received from donors who see promise in his work and in educating tomorrow’s surgeons.
One donor who wishes to remain anonymous says her reasons for supporting Mahoney run deep: “My husband has dementia. Understanding what he needs can be a challenge. Dr. Mahoney is such a compassionate doctor, he was able to figure it out and help,” the donor says. “We want to help train more doctors to be just like him.”
For his part, Mahoney deflects the praise, chalking his success up to the remarkable Johns Hopkins milieu where so many talented people are gathered and share a sense of common purpose. “There’s just such commitment to learning and teaching at Wilmer and Johns Hopkins,” he says. “It’s hard not to be inspired in this place.”