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Biographical entry Tessier, Paul Louis (1917 - 2008)

MD Nantes; Hon FRCS 1984.

August 1917
Heric, France
6 June 2008
Craniofacial surgeon


Paul Tessier was a giant of surgical innovation who gave hope to many with severe facial deformities by developing the specialty of craniofacial surgery. He was born in August 1917 in Heric, near Nantes, France, the son of a family of wine merchants. He began his medical training in Nantes in 1936, but his studies were interrupted by the Second World War and he was interred as a prisoner of war in 1940. A year later he developed typhoid myocarditis and was released from detention. He continued his studies, but in 1943 Nantes was heavily bombed by the Allies and the hospital was destroyed. Tessier moved to Paris, where he found work in an administrative post and then as a steelworks medical officer. In 1946 he was appointed to the paediatric department at Hôpital Foch, in Paris, where he carried out his ground-breaking work. By the mid-1950s he had become head of his department.

From the late 1940s he made regular trips to the UK to learn from the plastic surgeons Sir Harold Gillies and Sir Archibald McIndoe, who were developing ways of responding to severe military injuries. Decades later he established a connection with Great Ormond Street Hospital, carrying out the first craniofacial procedures in the UK in 1971. He was a visiting professor there into the 1990s.

He became interested in the treatment of cleft lip and palate, and developed the classification of facial clefts which bears his name. In 1957 he was introduced to a patient with a severe facial deformity, a condition now known as Crouzon syndrome, characterised by poor development of the upper jaw and eye sockets. Tessier had the idea that it should be possible to free the facial skeleton from the cranium and reposition it. Anatomical research confirmed this and in the first case he was able to advance the facial skeleton 25mm and secure with bone grafts. Tessier also worked with the neurosurgeon Gérard Guiot to devise a technique for separating the eye sockets from the skull, to relocate the eyeball and protect vision.

In 1967 Tessier presented a series of cases at the International Congress of Plastic Surgery in Rome, to an audience of distinguished surgeons. Paris went on to become recognised as the birthplace of craniofacial surgery and attracted surgeons and trainees wishing to learn the techniques Tessier had pioneered.

The International Society of Craniofacial Surgery was founded in 1983 and Tessier was made honorary president. He received many other awards and accolades, including the Jacobsen innovation prize of the American College of Surgeons, the gold medal and Gillies lectureship of the British Association of Plastic Surgeons and, in 1984, an honorary fellowship of the Royal College of Surgeons. In 2005 he was awarded the Chevalier de legion d'honneur.

In his surgery nothing was left to chance. He is remembered for his tenderness and concern for his patients and his phenomenal capacity for work with long hours of operating. His interests away from surgery were big game hunting, sculpture, fine wines, food and cigars!
Paul Tessier died on the 6 June 2008. He was 90. He was survived by his wife Mireille and their two children.

Brian Morgan

Sources used to compile this entry: [The Independent 23 June 2008 - accessed 7 May 2015; BMJ 2008 337 693 - accessed 7 May 2015; The Telegraph - accessed 7 May 2015; The Guardian - accessed 7 May 2015; American Association of Plastic Surgeons Memoirs Paul L Tessier, MD 1917-2008 - accessed 7 May 2015; JPRAS September 2008, Vol 61, Issue 9, pp.1005-7 and 1008 - accessed 7 May 2015].

The Royal College of Surgeons of England