Berish Strauch, a plastic surgeon whose pioneering procedures and units to reattach or exchange very important physique components included one of many first toe-to-thumb transplants, a tool to reverse vasectomies and, maybe most notably, the primary inflatable prosthetic penis, died on Dec. 24 in Greenwich, Conn. He was 90.

His daughter, Laurie Strauch Weiss, stated the reason for his dying, in a hospital, was respiratory failure.

Starting within the late Sixties, Dr. Strauch was on the forefront of a revolution in cosmetic surgery, particularly microsurgery, by which docs use microscopes and precision devices to stitch collectively minuscule blood vessels, nerves and ligaments, some thinner than a human hair, stated Dr. June Okay. Wu, an affiliate professor of surgical procedure at Columbia College who accomplished her residency below Dr. Strauch.

Because the longtime chief of reconstructive surgical procedure at Montefiore Medical Heart within the Bronx, Dr. Strauch devised lots of the surgical procedures and applied sciences that at the moment are thought-about commonplace. Amongst different achievements, he pioneered methods to take away extra pores and skin from sufferers who had misplaced vital quantities of weight from bariatric surgical procedure — a kind of excessive tummy tuck.

After a New York Metropolis firefighter misplaced his thumb in 1976, Dr. Strauch tried to reattach it. When that proved not possible, he recommended one thing extra radical: taking one of many man’s massive toes and stitching it instead of the severed digit.

Not solely did the surgical procedure work, however inside a number of months, the firefighter was again on the job.

“I don’t suggest a transplant for an individual who has misplaced a finger,” he advised the newspaper Midnight in 1976. “A thumb, sure, as a result of the opposable thumb is what differentiates us from beasts.”

Dr. Strauch was among the many first fashionable surgeons to make use of leeches to assist management blood stream after surgical procedure and take away necrotic tissue — a seemingly medieval approach that, he stated, couldn’t be improved upon by human innovation.

“Should you needed to exit and design an instrument to take away blood,” he advised The New York Instances in 1987, “you couldn’t design one which was extra suited than the biblical leech.”

He left an particularly deep mark on the sphere of urology. He created the so-called Strauch clamp, a tool used to help in reversing vasectomies. And in maybe his most exceptional however no much less necessary innovation, he invented the primary inflatable penile prosthesis.

Synthetic penises had been in use for hundreds of years, both as replacements for indifferent members, as therapy for erectile dysfunction or to be used in intercourse reassignment surgical procedure. However normally they had been both completely flaccid or completely erect — neither of which was an particularly satisfying association for anybody concerned.

Dr. Strauch devised a prosthetic penis hooked up by a tube to a reservoir of fluid implanted contained in the physique. When the affected person needed an erection, he might activate a pump to fill the prosthesis (although to reverse it, he would wish to work the fluid again into the reservoir manually).

He obtained a patent for his invention in 1973, after which he offered it to an organization referred to as American Medical Techniques. One of many firm’s founders, F. Brantley Scott, then additional developed the product — and within the annals of medical historical past has since obtained many of the credit score.

Berish Strauch was born on Sept. 19, 1933, within the Bronx, the son of Herman and Anna (Weiss) Strauch. His father lower males’s fits in Manhattan’s garment district; his mom was a milliner.

As a baby, Berish, who glided by Bob in casual conditions, accompanied his dad and mom to their work. He later stated that watching them wield scissors and knives for hours impressed his curiosity in surgical procedure.

He attended the Bronx Excessive Faculty of Science and graduated from Columbia, the place he studied pre-med, in 1955 and from its medical college in 1959. After fellowships at Roosevelt Hospital in New York and Stanford Hospital in Palo Alto, Calif., he returned to the Bronx to hitch the workers at Montefiore. He turned chief of cosmetic surgery there in 1978.

Dr. Strauch married Rena Feuerstein in 1955. She died simply eight weeks earlier than he did. Together with their daughter, he’s survived by their son, Robert, himself a famous hand surgeon; seven grandchildren; and his sister, Renee Freed. The Strauchs lived in Rye, N.Y.

Although he by no means sought consideration, Dr. Strauch performed a minor however necessary position in one of many largest tabloid tales of the Nineteen Nineties.

In 1992 Amy Fisher, a teen from Lengthy Island, shot a lady named Mary Jo Buttafuoco within the facet of the pinnacle after confronting her over Ms. Fisher’s affair with Mrs. Buttafuoco’s husband, Joey.

Mrs. Buttafuoco survived, however she suffered huge facial harm, together with partial paralysis. Listening to about her case, Dr. Strauch reached out to her lawyer and supplied to assist.

“This is without doubt one of the most fruitful areas of medication,” he advised Newsday in 1992. “Prior to now 20 years there was an entire new stage of data.”

He carried out in depth surgical procedure on Mrs. Buttafuoco in early 1993, returning most of her face to regular — although it was too late to reverse in depth nerve harm.

“She’s going to nonetheless have some parts of the paralysis primarily of the decrease lip,” he advised Newsday after the surgical procedure. “However she’s a ravishing girl, and she or he’s going to look nice.”