Carmel Valley doctor helps transform lives of children afflicted with deformities

By Arthur Lightbourn

He didn’t say so, but a “flanker” rugby player has to be fast, strong and tenaciousness or he won’t be playing for long — and that’s the position Dr. Salvatore Pacella played in that British-style version of football until he “retired” at 35 three years ago to referee college and high school matches in his spare time.

Pacella, (pronounced “Pa-chella) at 38, also has a day job as a private practice plastic surgeon and the youngest physician to be appointed division head of plastic and reconstructive surgery at Scripps Clinic.

And he’s one of 600 San Diego surgeons, dentists and health care workers who volunteer their time and skills, through the Fresh Start Surgical Gifts Foundation, to transform the lives of uninsured infants, children and teens suffering from deformities caused by birth defects, accidents, abuse or disease.

As a facial reconstructive plastic surgeon, Pacella has volunteered at more than 20 Surgery Weekends conducted at Rady Children’s Hospital.

Fresh Start hosts six to seven Surgery Weekends each year, dental clinics 13 times a year and provides free follow-up medical services and additional surgeries as long as needed. Since its incorporation in 1991, Fresh Start has provided more than $20 million worth of free medical services for more than 5,500 children from the U.S. and overseas.

Pacella’s private practice includes all aspects of cosmetic, plastic and reconstructive surgery, with a specialized interest in facial, oculoplastic (eyelid) and breast surgery.

We interviewed Dr. Pacella in his office at Scripps Clinic Rancho Bernardo.

He has an enthusiastic, energetic, youthful manner, and the tell-tale stocky build of a former rugby player-turned rugby referee. He is also the father of a seven-month-old boy.

Pacella was born in Buffalo, New York, the son of a GM auto worker. His grandfather, who is now 92, served in the Italian Army in World War II and was a POW in Greece, before immigrating to Buffalo.

Growing up as the middle child in a family of three children, where education was viewed as the key to a better life, Pacella was drawn to the idea of becoming a doctor while in high school — as a career where you could help people, “and not have to punch a ticket.”

“It seemed like a fantastic career which was wide open. You can help the very old and very young, and particularly in plastic surgery, it’s not the kind of job where you’re ever going to get bored, because every surgical problem is unique, every wound is different and every [facial] cancer is in a different place.”

Also in high school, he played football and dreamed of continuing to do so at an Ivy League college like Columbia, but, instead, he won a full academic scholarship to Saint Bonaventure University in upstate New York where they played rugby instead of football.

“As the school year started,” he recalled, “I really missed the feeling of ‘strapping on the pads’ and became a little depressed that football was over for me. A good friend of mine recruited me to join the rugby team, and I immediately loved it and have loved it ever since.”

Pacella went on to earn his undergraduate degree in biochemistry, summa cum laude, from Saint Bonaventure in 1995; his medical degree from the University of Rochester, Rochester, N.Y., in 1999; followed by his internship and residencies in plastic surgery at the University of Michigan, Ann Arbor, 1999-2007; and additional subspecialty fellowships in aesthetic and oculoplastic cosmetic surgery at centers in Atlanta and Marina Del Rey in 2007-2008.

He joined Scripps in 2008.

He also holds an M.B.A. from University of Michigan’s Ross School of Business in finance and health care economics.

“And that’s been very critical and instrumental in my career,” he said, “because it brought a different perspective that most physicians don’t have.

“In business school, a lot of issues are tackled in a team-oriented approach,” which provided valuable insights when working in a larger health system, such as Scripps, and understanding the issues involved in delivering health care today.

Whereas in medical school, he was taught to be the sole provider of many services to a patient, in 2011, in larger health care systems, where many different providers are responsible for various patient services, Pacella said, “It’s important to work as a team to deliver efficient and appropriate health care.”

He’s also big on providing pro bono services through the Fresh Start Surgical Gifts program “because a lot of times in medicine, we can get into a rut of the daily grind, dealing with insurance companies and Medicare, and lose perspective … but when we step back and do this kind of work, it takes all that stuff out of it — the insurance companies and the government — and it’s really about the doctor/patient relationship again. And that’s really important for me to remind myself of quite frequently and that’s what all these Surgery Weekends do. And it really helps me to take care of all the rest of my patients.”

He regards plastic surgery both as a science and an art.

The art aspect comes from being able to visualize not only the short-term results of a surgery, “but how it will look a year from now.

“It’s a very exciting time to be in plastic surgery,” he said, “particularly in the reconstructive aspect of things.

“There is a tremendous amount of work being done on tissue engineering, on integrating human nerves into muscle fibers for prosthetic arms, and human tissue transplantation in the face and hand.

“As medicine improves and tissue engineering improves,” he ventured, “I think someday we’re going to be able to take a stem cell from somebody’s blood, and build them a new ear, a new nose or new breast.

“That’s very exciting. It’s going to be many years from now, but really some of that groundwork is being laid today.”

More information on the work of Fresh Start is available online at:

Quick Facts


Salvatore J. Pacella, M.D., M.B.A., F.A.C.S.


Dr. Pacella is the recently appointed division head of plastic surgery at Scripps Clinic. At 38, he is the youngest physician to hold that appointment.

Resident of:

Carmel Valley


Buffalo, New York


B.S. in biochemistry, summa cum laude, Saint Bonaventure University, N.Y., 1995; M.D., University of Rochester School of Medicine, 1999; internship and residencies in plastic surgery, University of Michigan, Ann Arbor, 1999-2007; M.B.A., finance and health care economics, Stephen M. Ross School of Business, University of Michigan, 2005.


He and his wife, Jennifer (nee Flegier) were married in 2005. They have one son, Grady, 7 months, and one dog.


Refereeing college and high school rugby matches.


“A People’s History of the United States,” by historian and political scientist Howard Zinn.

Favorite getaway:

Palm Springs, Calif.

Favorite TV:

“Breaking Bad,” and “Boardwalk Empire.”

Favorite film:

“Inception,” 2010 sci-fi thriller starring Leonardo DiCaprio.


“Take good care of everyone around you and try to do everything with a sense of wonder and you’ll never get bored.”