Plastic surgery lost one of its international giants with the death of Daniel Marchac on October 15, 2012, in Paris, the city he called home for 75 years (Fig. 1). Surrounded by his adoring family and a phalanx of friends and colleagues, he was laid to rest in his family’s plot in suburban Paris on October 22nd. The interment was aptly described by one of those present who stated simply, “such a small coffin for such a big man.” For those of us who knew him professionally and personally, a bright flame had been extinguished in the City of Light.
Born on December 3, 1936, Daniel spent his formative years in the environs of Paris. The practice of medicine in the extended Marchac family went back several generations. His maternal great grandfather was a nobleman in Russia and was an ear, nose, and throat doctor to the Czar. His paternal great grandfather, a prominent jeweler, emigrated from Kiev at the time of the Bolshevik revolution. One of his paternal uncles became a renowned general surgeon in Paris, as did his son after him. Daniel himself entered medical school in 1954, completing his studies 6 years later. Between 1961 and 1962, he served in the French navy and passed his Concours de l’Internat des Hôpitaux de Paris, and had the opportunity to meet Paul Tessier at Hôpital Foch, which left a lasting impression (Fig. 2). Between 1962 and 1968, Daniel completed his general and plastic surgery residencies under the direction of professors Claude Dufourmentel, Dr. Daniel Morel-Fatio, and Dr. Roger Mouly. It was during this period that his interest in facial deformities began, as he spent off-duty hours observing Tessier at Foch. 1968 afforded Daniel a traveling fellowship in the United States, where he spent 6 months in Miami with Ralph Millard, 3 months in New York with John Converse, and 3 months in Houston with Tom Cronin. Capitalizing on this experience, Daniel returned to Paris, where he became Chief of the Clinic at Hôpital Saint Louis. It was there that he first described the modification of the Rieger flap for the correction of nasal deformities, which today is often referred to as the Marchac flap.
Beginning in 1971, Daniel entered the arena of craniofacial surgery, with his first transcranial remodeling procedures at Hôpital Lariboisiere. In 1976, he established the Craniofacial Unit at Hôpital Necker-Enfants Malades with pediatric neurosurgeon Dr. Dominique Renier, who would become his lifetime friend and colleague. He was a pioneering surgeon for the treatment of infants with craniofacial deformities, much against the wishes of Paul Tessier. His publication of one of the earlier textbooks of craniofacial surgery in 1982 demonstrated both the safety and efficacy of these procedures in children (Fig. 3).
Following a 1977 tour of the major craniofacial centers in the United States, Daniel became a member of the International Craniofacial Club, along with Ian Jackson, Fernando Ortiz-Monasterio, Ian Munro, Kenneth Salyer, and Linton Whitaker. The group was founded in 1972 and met annually, and spontaneously much more frequently, to exchange ideas about craniofacial surgery. Their meetings continued for the next 40 years and eventually led to the concept of an international society for the serious study of craniofacial surgery. Daniel was thus a key founding member of what came to be known as the International Society for Craniofacial Surgery. Its first meeting was held in 1985 in La Napoule, France, with Tessier serving as its first president and Daniel as the meeting organizer and scientific program chairman (Fig. 4).
At the same time that Daniel was pioneering infant craniofacial surgery at Hôpital Necker, he also was developing a busy practice in aesthetic surgery dealing primarily with facial cosmetic surgery and surgery of the breast. During his career he published more than 160 scientific articles focusing on refinements in face lift surgery, rhinoplasty, surgery of the breast (short-scar mammaplasty), and craniofacial surgery. He edited and wrote five books and 23 book chapters.
Over his 44 years of practice in plastic surgery, Daniel was instrumental in helping organize many important scientific societies. In 1974 he was founding member of the “European” Alpine Workshop, which served as a model for the establishment of a similar organization in North America, The American Alpine Workshop in Plastic Surgery, founded in 1990. Daniel became a foreign associate in 1993. In 1989 he was instrumental in the founding of the European Association of Plastic Surgery, which modeled its bylaws and membership requirements after those of the American Association of Plastic Surgeons. Daniel became the first elected member of the American Association of Plastic Surgeons and was given the honor of being made a Distinguished Fellow in 1999. He became the first Secretary General of the European Association of Plastic Surgery, and served as its 1998-1999 president. In 1991 he was appointed Professeur au Collège de Médecine des Hôpitaux de Paris, a position that he maintained until the time of his death. He served as president of both the International Society for Craniofacial Surgery (1993 to 1995) and the Société Française de Chirurgie Plastique Reconstructice et Esthétique (1997 to 1998). Due to his meritorious efforts for the advancement of surgery, particularly in infants with craniofacial deformities, Daniel was decorated with the Chevalier de la Legion d’Honneur in 2001, the highest honor given to a civilian in France. The award was presented to him by the then Minister of Health Bernard Kouchner, with the sitting Prime Minister, Lionel Jospin, in attendance.
North American colleagues honored him with the Maliniac Lectureship in 2002 at the American Society of Plastic Surgeons, on the twenty-fifth anniversary of its founding. In 2006 he was appointed the International Society of Aesthetic Plastic Surgery Traveling Professor. Daniel remained academically and clinically active right to the end, and even in his final months saw the publication in Plastic and Reconstructive Surgery of his final paper on his vast experience in the treatment of orbital hypertelorism which had been presented at the European Association of Plastic Surgery meeting in May of 2012.
For more than 30 years Daniel maintained a fellowship in both craniofacial surgery and aesthetic surgery, allowing young surgeons from other parts of the world the opportunity to come to Paris and be exposed to this master surgeon as well as to the cultural riches of Paris. The Broken Davidoff Club, as it was fondly called by former fellows, would routinely meet spontaneously at international meetings when Daniel was in attendance. Daniel was both a superb soft-tissue surgeon and bone surgeon, with techniques and instrumentation readily adopted by his students. Many of these former fellows have gone on to become excellent teachers themselves and leaders in all aspects of plastic surgery in their respective countries. Daniel’s youngest son, Alexandre, spent 6 months with his father as a fellow in 2008. His son-in-law, Gerald Franchi, is also a plastic surgeon and practices in Paris. The Daniel Marchac legacy certainly lives on.
Those who knew Daniel loved him for his kind and gentle manner in addition to his great surgical abilities. He was a “renaissance man” in the truest sense of the word. For many of us, going to Paris will never be the same knowing that our beloved teacher, friend, and mentor is no longer with us. He will be sorely missed by the entire world of plastic surgery.