1008 Obituaries

Obituary- Dr. Paul Tessier

Born 1917 died 6 June 2008Paul Tessier is known throughout the world as the father

of craniofacial surgery.He created a new specialty that was aimed at treating

those patients with the severest of craniofacial deformitiese the craniosynostosis syndromes of Apert, Crouzon,Pfeiffer etc together with the dramatic clefts of the face,the classification of which bears his name.

His motivation was to give these people a chance in life.In pursuing this goal his influence has been felt at philo-sophical, scientific, technical and organisational levels insurgical practice.

Paul Tessier was born in Nantes in 1917 and went tomedical school there from 1936 to 1943 with a sixteenmonth interruption caused by the war. War time saw himspend a period as a prisoner of war, contract typhoidmyocarditis and narrowly escape friendly fire in the form ofallied bombs.

Towards the end of the war he moved to Paris and joinedthe Paediatric Surgical Service at the Hopital St. Josephwhere Georges Huc was the chief. Paul wrote of him as ‘aman, a humanist, a functionalist, a gentleman and mypatron——a father whose qualities one would love toinherit.’ It is notable that Huc was the trainee of Morestin,of plastic surgical fame in Paris during World War 1, whowas himself a source of Gillies’ early inspiration andknowledge. That loop was closed when Tessier travelled toGreat Britain in 1946 to visit and work with Gillies, McIndoeand Mowlem. During this time he met John Barron whom heconsidered the best soft tissue surgeon he had ever seen.

Tessier had been influenced in his surgical developmentby an early association with cleft lip and palate treatmentand later by a stint in an ophthalmology service in Nantes.

An early post war appointment at the Hopital Foch sawhim involved with facial trauma and the almost inevitableadministrative and interdisciplinary conflicts that are somuch of surgical life. His response as always was to persist.

Circumstances seem to have readied Paul Tessier for thechallenges that presented in 1957 in the form of a patientwith Crouzon syndrome - an extreme deformity of the faceand skull. In typical fashion Tessier researched the litera-ture, made the diagnosis, worked on dried skulls andconferred with colleagues. Gillies had attempted to movethe face of a young Portuguese woman in the early 1940s.He and others present had concluded that this was a diffi-cult and dangerous venture and that it was to be discour-aged. Tessier’s attempt was successful. He used primarybone grafting to stabilise the face but, most importantly,he established a close association with the neurosurgeon,Guiot, and with this interdisciplinary approach togetherwith detailed anatomical observations and meticulousplanning he went on to describe the ‘craniofacialapproach’. It is said that when he asked his neurosurgicalfriend if it could be done the reply was ‘pourquoi pas?’ (why

not?) - this phrase has been adopted as the logo of theInternational Society of Craniofacial Surgery.

In typical European academic fashion, Tessier presentedhis work to his peers for comment and criticism in 1967.From that time onwards Paris, the Foch and his privateclinic at the Belvedere became the centre where the firstgeneration of craniofacial surgeons was trained. Theatmosphere of excitement, passion, science and dedicationwas infectious for the surgeons who came from around theworld to learn.

In 1971 Tessier performed surgery at The Hospital for SickChildren at Great Ormond Street in London. The problemsencountered only served to underline the difficult nature ofthe work that he had started and the need for experiencedteams. He continued his United Kingdom attachment fora further 25 years. In the same year he presented a paper atthe international congress of plastic and reconstructivesurgery in Melbourne,Australia that setout guidelines for unitstructures and standards for teaching in the new discipline.

In 1983 Paul Tessier became the first president of theInternational Society of Craniofacial Surgery, the otherseventeen founding members of which had been inspired byhim and would continue and develop his heritage aroundthe world.

Much emphasis has and should be placed on Tessier’sconsummate surgical skills and the techniques that hedeveloped and passed on to other surgical disciplines. Ofequal merit however was his practice of meticulousanatomical study and careful research prior to treatment.As a result of his example most of the craniofacial defor-mities are now the subject of intense research andimproved understanding.

His concepts of multidisciplinary care have beenenhanced and institutionalised, the four craniofacial unitsin England being examples.

Above all there are countless thousands of people whowould never have had a chance of a decent life if PaulTessier had not passed this way.

He remained an active participant in craniofacial affairs,visiting his colleagues, attending scientific meetings andreviewing his own data.

He was the recipient of many awards including the Legiond’Honneur in 2005, the Jacobson Innovation Award by theAmerican College of Surgeons, and the Gillies lectureship andGold Medal by the British Association of Plastic Surgeons.

Paul Tessier was a remarkable man e Vale.He is survived by his wife of 35 years Mireille, and by his

son and daughter.

David DavidProfessor of Craniofacial Surgery, Adelaide,

South AustraliaE-mail address: ddavid@ddms.com.au

doi:10.1016/j.bjps.2008.07.005