Daniel Marchac, 1936-2012

Daniel Marchac was born on 3rd December 1936 in Paris.  He was of Russian extraction, the family having left Russia after the revolution in 1917 and settled in France. There was a surgical line running from a great-grandfather, Baron General Alexandre Von Spengler, who was an ENT surgeon in St. Petersburg counting the Tsar among his patients, to his father’s cousin Victor Marchak, a general surgeon in Paris after the 1914-18 war. The spelling of the family name was changed after the second World War to Marchac rather than the original Marchak.

Daniel’s became the head of the family at the age of 13 when his father, a successful railway engineer, sadly died. The young Daniel reassured his mother that he would always take care of her, a promise that he fulfilled till the end of her life, in her 90s. He lunched with her every Thursday sitting in the same chair he had done as a child! Daniel’s interest in surgery was stimulated at the age of 15 when he read an article on orbital surgery, unbeknown to him, a commentary on Paul Tessier’s pioneering early work in craniofacial surgery.  He studied in medical school in Paris and after military service pursued a general surgical and plastic surgical residency with three highly regarded surgeons – Professor Dufourmentel, Dr Morel-Fatio and Dr Mouly. Whenever possible Daniel also took the opportunity to watch Tessier operate. Unusually for a European at the time, in 1968 he travelled to America to study with three American plastic surgical giants – Ralph Millard in Miami, John Converse at NYU and Tom Cronin in Houston. His training gave him an unusually wide view of plastic surgical techniques and the wider world, combining the best of Europe and North America. When he returned to Paris he was appointed Chef de Clinique at the Hôpital Saint Louis. During the two years he spent there, from 1968 to 1970, he described a modification of a frontonasal flap used for resurfacing large nasal defects which later became known as the Marchac flap

His early interest in craniofacial and orbital surgery had not dimmed and between 1971 and 1976 he began craniofacial remodelling procedures with neurosurgeon Dr Cophignon at the Hôpital Lariboisière. It was in 1976, however, when he gained a consultant position at Hôpital Necker-Enfants Malades (the Parisian equivalent of Great Ormond Street) that he was able to establish a formal craniofacial unit with his friend and neurosurgical colleague Dominique Reinier. Daniel and Dominique pioneered the use of transcranial craniofacial techniques to correct congenital defects in very young children. Such surgery in the young had previously been thought to be impossible but they identified a number of craniofacial deformities which could be treated advantageously in very young children, taking advantage of the expansion of the brain in early life to continue to mould repositioned facial and cranial bony segments.  In 1982 they published a book summarising their techniques and the outcome of craniofacial remodelling in 156 patients before the age of two years. At around the same time, Daniel combined with other international leaders in the field and the concept of the International Society of Craniofacial Surgery emerged. It’s first meeting was in La Napoule, France in September 1985. The society flourishes now and continues to be the leading international forum for craniofacial surgery.

Daniel was a very keen teacher and at an early stage in his career established a Fellowship that was open to young surgeons from around the world to spend 6 months working with him. This was an outstanding opportunity to learn craniofacial techniques, particularly as applied to young children, together with a broad range of reconstructive and aesthetic plastic surgical procedures. I was fortunate enough to be his Fellow in 1985 which was an extraordinarily happy period for me and changed my life and philosophies. Daniel regarded the Fellowship as an education not only in plastic surgery, but also in life. So, in addition to the surgical technicalities, there was very practical teaching in French culture, art and gastronomy on a daily basis. A day without a proper, if brief, lunch was unthinkable and if time became available unexpectedly he would not waste it, rather he was likely to suggest a visit to the Rodin museum or another of the many galleries and museums in Paris. The first question he asked when I had returned to take up my consultant position at Great Ormond Street was “Are you still eating lunch?”

Daniel had been impressed at the academic standard when attending the American Association of Plastic Surgeons, an elite group to which distinguished surgeons were elected, meeting once a year to present their work. No such organisation existed in Europe. He invested a great deal of time, effort and energy in realising his vision of a similar forum and in 1989 founded the European Association of Plastic Surgery (EURAPS). Daniel was it’s general secretary from 1989-1995 and, initially organised on similar lines to it’s American counterpart, EURAPS has developed into an organisation facilitating the presentation of original academic and clinical work of the very highest calibre at its annual meeting. To be elected a member of EURAPS is considered an honour and many would argue that its standards of academic excellence are now higher than the body from which it was born.

Daniel travelled the world tirelessly teaching and lecturing. He can be credited with bringing the excellence of modern European plastic surgery to the notice of the North American surgical community and he spent much time in the far east, especially China,  helping to establish craniofacial surgery there. In 2002 he was honoured to be asked to deliver the 25th anniversary Maliniac lecture and in 2007 received the Special Achievement Award of the American Society of Plastic Surgery. He travelled to the UK often, where he had many friends.  He was greatly admired and respected and was an honorary member of the British Association of Plastic Reconstructive and Aesthetic Surgeons.

Daniel published widely on his three particular areas of surgical interest – craniofacial surgery, skin tumours and aesthetic surgery. He cared for a cohort of over 1500 craniofacial patients and their families at Hôpital Necker, one of the largest in the world. Technically he never rested on his laurels, always seeking to improve outcomes and latterly was one of the pioneers of craniofacial osseous distraction techniques.

In 2001 Daniel was decorated with the Chevalier de la Légion d’Honneur – the highest civilian decoration in France.

Despite the many academic achievements and honours bestowed upon him, Daniel’s personal qualities, for those of us who knew him well, outweighed his professional achievements.  He was unusual perhaps for a highly successful, politically active international surgical figure in that he was both a gentle man and a gentleman. He had a unique charm and charisma and even during the last year of his life, when undergoing very aggressive chemotherapy for a lymphoma, he remained unwaveringly optimistic. He enjoyed life to the full – he was a keen and successful sailor, an appreciator and collector of art from around the world, a hardy and enthusiastic traveller and, as befits a great Frenchman, a great appreciator of fine food and wine. He became fascinated by a family jewellery business started by another great grandfather, Joachim Marchak, in Kiev.  He collected vintage pieces and became involved in the creation and manufacture of new jewellery in the Marchak style.  Had he lived, this was one of his planned projects for retirement. He was much loved by his many Fellows who created “the broken Davidoff Club” in his honour, named after the small cigars which he enjoyed at the end of a meal, most of which were broken by the case in which he carried them!

A very committed and loving family man Daniel is survived by his children – Gregoire and Valentine from his first marriage, his wife Nina and their children, Natalie and Alexandre.  His contribution to European plastic surgery, craniofacial surgery and surgical education was immense. To me and to many others he was a lifelong mentor and friend and is irreplaceable.

Barry M Jones