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Ivo Pitanguy, M.D., 1923 to 2016

2017; Lippincott Williams & Wilkins; Volume: 139; Issue: 3 Linguagem: Inglês

10.1097/prs.0000000000003112

1529-4242

John M. Holzer, Thomas M. Biggs, Henrique N. Radwanski,

Biomedical Ethics and Regulation

Ivo Pitanguy died on August 6, 2016, of cardiac arrest in Rio de Janeiro after a remarkable 93-year life—1 day after helping relay the Olympic torch to the Rio Games from a wheelchair. Pitanguy leaves behind wife Marilu and children Ivo Junior, Gisela, Helcius, and Bernardo (Fig. 1).Fig. 1.: Ivo Pitanguy. In 1960 at the inaugural address of his postgraduate school of plastic surgery, Ivo Pitanguy observed: “A peculiarity of great men, besides their talent, whether they be philosophers, painters, or strategists, is that they founded schools. Plato, Rubens, and Clausewitz all had students. The great man knows that a solitary genius is fated to be forgotten. To be remembered, he must spread his knowledge.” Pitanguy himself shall be long remembered by his students, colleagues, patients, and a grateful global public.Pitanguy led plastic surgery from obscurity and ridicule after the Second World War to prominence and respect today—improbably starting from Brazil, then a southern hemisphere medical backwater. Pitanguy devised key operations of the head and body, launched the specialty’s first dedicated hospital, opened his operating theater to all plastic surgeons eager to learn the latest innovations, founded what became its largest postgraduate school worldwide, inaugurated its lone charity clinic bringing beauty and reparative surgery to the impoverished, published hundreds of scientific articles and best-selling books, lectured at scores of international conferences annually, formed lifelong friendships with the art’s leading practitioners and his own students, and for more than a half century explained the profession’s importance to a worldwide public largely ignorant but eager to learn. A great humanist, Ivo proclaimed everyman’s right to dignity, democratized plastic surgery, and changed global culture. He sensed his patients’ physical and psychic pain while conversing in their own English, French, Spanish, Italian, or German, or in his native Portuguese. Ivo Hélcio Jardim de Campos Pitanguy was born of aristocratic Brazilian bloodlines in Belo Horizonte to general surgeon Antônio de Campos Pitanguy and genial, cultured Staël Jardim Rabelo. In the frontier days of the mid nineteenth century, his paternal great grandfather, Antônio Soares, moved from one small village, Pitanguy (an indigenous Tupi-Guarani name for a small stream where children bathe), to another, Curvelo, where he acquired vast landholdings and became known as Pitanguy. One of Staël’s forebears led an honor guard to protect Brazil’s first emperor as the ruler declared independence from Portugal in 1822. Another was instrumental in abolishing slavery and ending the monarchy. Ivo joined his ancestors with a penchant for shaking up the status quo. He grew up in a literary household with brother businessman Ivan and sisters Ivete (the first Petrobras female lawyer and mother of a three-time world bridge champion), architect Yeda Lucia, and Brazilian women’s rights pioneer Jacqueline. The family spoke French at home and recited passages from Shakespeare, Goethe, Cervantes, and Molière. As a teenager, he witnessed operations in his father’s operating room and entered Rio’s National School of Medicine, earning an M.D. degree in 1946. While an intern, he worked at Rio’s Emergency Hospital, rode ambulances into its shantytowns, and learned to minimize scarring while stitching up men lacerated in knife fights or battered by traumatic blows. In 1948, he won a coveted scholarship to practice at the Bethesda North Hospital in Cincinnati as the first plastic surgery resident of Professor John Longacre. Ivo also observed operations at the Mayo Clinic, Johns Hopkins, and John Converse’s Manhattan operating room. In 1951 in Paris, he assisted hand surgery pioneer Dr. Marc Iselin. One year later, in England, plastic surgery trailblazers taught him the state-of-the-art: Sir Harold Gillies, aesthetic surgery; and Archibald McIndoe, burn surgery. When Pitanguy returned to Brazil in 1952, plastic surgery was virtually unknown, but Rio de Janeiro was the world capital of beach culture and beauty worship. He soon brought aesthetic surgery to his countrymen and to a few American and European movie stars vacationing in Rio. The Carioca press dubbed him the “Michelangelo of the Scalpel.” Latin American doctors forwarded extreme burn and reconstruction cases. His charity infirmary opened in 1959 and eventually treated over 60,000 patients at zero or bargain prices and provided a training ground for his residents. Children born with cleft palates and shunned by classmates received state-of-the-art facial restoration and as adults made friends, married, and had families. Women from the favelas sported the same smart looks as those of Rio’s upscale neighborhoods. Suddenly, in 1961, Ivo Pitanguy became nationally loved and intercontinentally famous for organizing burn treatment of hundreds after the Brazilian circus tent fire that killed over 500. In 1962 he inaugurated the planet’s first plastic surgery hospital in Rio—Clinica Ivo Pitanguy. There he developed signature operations whose key elements are in widespread evidence today: reconstructive (abdominoplasty, breast reduction, and deformities) and aesthetic (relaxed face lifts and body contouring). Now, surgeons the world over use “Pitanguy markers” for face lifts and tummy tucks. Ivo also practiced internationally. In 1968, Italian President Fanfani summoned him to perform reconstructions in Rome, and over 2 years Pitanguy helped inaugurate the country’s plastic surgery. In 1969, for nearly a decade, with a local surgeon, the Brazilian operated in Switzerland on European patients for 4 weeks per year. Springer-Verlag published his Aesthetic Plastic Surgery of the Head and Body, heralded at the 1981 Frankfurt Book Fair as the best scientific work. Two years later, Pitanguy published the first of several memoirs, Les Chemins de La Beauté (The Ways of Beauty), translated into Portuguese as Direito á Beleza (The Right to Beauty), best sellers in France and Brazil. With regularity, the planet’s elites—kings, emperors, presidents, first ladies, movie stars, painters, singers, moguls, writers, and a Formula 1 driver—sought Pitanguy to freshen their appearance or deal with deformities and burns. Ivo’s multilingual conversations with friends and celebrities gravitated toward literature, art, ecology, martial arts, tennis, classical music, scuba adventures, or the jet-set social calendar. Soon, he and wife Marilu became a fixture at their soirees and weddings. In turn, they mingled at his Rio mansion, Brazilian mountain estate, Gstaad chalet, Parisian flat above the House of Dior, and famed Brazilian tropical island. He collected works of Picasso, Magritte, and Chagall, and decorated an entire room with works by Dalí after years of paling around New York and Paris with amigo Salvador. Over a long life, nuclear-fueled Pitanguy stayed physically fit. At sunrise, he swam, played tennis, or sharpened his black belt karate moves—ahead of long days in scrubs and late evenings in a tuxedo—subsisting on 4 or 5 hours of sleep. On weekends, he spearfished dinner for island guests. The most prominent word in Ivo’s vocabulary was friend, and he constantly sought friendships with those of every occupation, avocation, nationality, and social standing. He charmed the ladies and won the respect of the men. His soft voice, quick chuckle, broad smile, caring nature, and sincere, nonjudgmental interest in their lives put people at ease and boosted their self-esteem. In 1972, when newly minted surgeon Tom Biggs first visited Rio de Janeiro, Pitanguy unexpectedly arrived at the Copacabana Palace, chauffeured him to Ivo’s hillside quarters, and seated him between the chief executive officer of AT&T and a French banker at an 8-foot circular mahogany dinner table. The Brazilian led a conversation in English and French that meandered through European history, modern art, and medical advances—all the while translating for the young American and seeking his confirmation or elaboration. In the operating theater the next day, Ivo persistently sought the neophyte’s suggestions. Tom left Brazil determined to adopt Pitanguy’s kind, solicitous treatment of everyone, be they patient, resident, or janitor—sentiments likely shared by the thousands who met the maestro at the profession’s international conferences over the next 43 years. In the New York Times, Der Stern, Le Figaro, Vogue, and other publications, he spoke of the profession’s philosophy, advances, and promise, giving it respectability and high visibility. In Brazil, the popularity of plastic surgery exploded. The Brazilian Society of Plastic Surgery was founded in 1949 with 14 members. Today, it has 5200. The much poorer country consumes more plastic surgery per capita than the United States. From the slums and beaches of Rio de Janeiro, to the factory floors and corporate suites of São Paulo, to the halls of congress and the presidential palace in Brasília, Brazilians universally venerated Pitanguy. Almost daily, their media recorded his pronouncements and tracked his movements around the globe. They admired Pitanguy for attracting the world’s elites to their nation. They revered him for tending to the poor. The popular Brazilian collected hundreds of medals and accolades over a half century. In 1970, Brazil’s president conferred the country’s highest award on Ivo and soccer legend Pelé. Three years later, Pitanguy became the first plastic surgeon admitted to Brazil’s National Academy of Medicine and in 1991 the only doctor ever elected to the 40-member Brazilian Academy of Letters. In 1989, Pope John Paul II presented him with the Italian Peace Prize. In 1986, French President François Mitterrand admitted Pitanguy to the French Legion of Honor with the rank of Chevalier, and successor Jacques Chirac promoted him to Officier in 1997. In 2009, the American Society of Plastic Surgeons summoned Pitanguy to deliver the prestigious Maliniac Lecture. Yet Pitanguy’s greatest honor was to educate three generations of plastic surgeons as their professor. Ivo Pitanguy lives on through more than 600 of his alumni who practice in over 40 countries, congregate annually at different international destinations, and hold fond memories of their mentor and friend. They feel blessed to have learned from whom they regard as history’s greatest plastic surgeon and Brazil’s Renaissance man.