[Innovation in craniofacial surgery: From Tessier to future prospects. According to testimonies of F. Ortiz-Monasterio, D. Marchac, F. Firmin and T. Wolfe].

Innovation is one of the founding values of plastic surgery. By its fundamental innovations, Paul Tessier (1917-2008) created craniofacial surgery in the sixties. The exploration of the new field, which has modified the boundaries of knowledge, has been evoked by Fernando Ortiz Monasterio, Daniel Marchac, Françoise Firmin and Tony Wolfe. This work defined the human qualities leading to creative breakthrough: (1) rigourous work and passion; (2) withdrawal from the current educative dogmas; (3) maintainance of the excellence of reconstructive and aesthetic practice; (4) progressive complexity of the procedures with concomitant validation by peers; (5) humility and continuous self criticizing maintained in one's own results. The main focus of those evolutions in craniofacial care at the forefront include among others: (1) functional imaging in order to help for mental prognosis assessment; (2) sophistication of biomaterials in order to limit morbidity; (3) ultimate developments of osteogenic distraction techniques; (4) genetic evaluation and counselling toward genetic therapies; (5) antenatal diagnosis toward in utero treatment. The necessity of well recognized reference centers for treatment of craniofacial anomalies is currently one of the healthcare priorities in Europe among the management of all are rare diseases (less than one out of 2000 living births).