 He also completed a fellowship in microsurgery at the University of California, San Francisco, with the microsurgical pioneer, Harry J. Buncke, and in hand surgery at the Curtis Hand Center in Baltimore.Maxwell was the surgeon and co-author of the first successful report of microsurgical transfer of the latissimus muscle flap, at Johns Hopkins University in the late 1970s.In the early 1980s, he relocated to Nashville, where he founded the Nashville Plastic Surgery Institute and established a fellowship training program in breast and cosmetic surgery.