A Tribute to Tony Bull—Surgeon, Teacher, Leader, Gentleman (1934–2016)

It is with a heavy heart that we report the loss of one of the founding editors of Facial Plastic Surgery, Mr. Tony Bull. Without the tremendous contributions from him and others, facial plastic surgery would not be the scientific yet artistic specialty it is today. We offer reflections on Tony Bull from those who knew him best.

On rare occasions an individual comes along who, through dint of dedication, purpose, leadership, and shining example, leaves an unshakable salutary impact on all who encounter him. A sterling example of the finest of British surgeons, the medical influence generated by Tony R. Bull reached far beyond the shores of England, extending to all who were privileged to know and learn from him. Tony Bull's illness has been painful for all who knew and respected him. He is a doctor's doctor, a teacher of the highest order, and a loyal son of his university. His friendship and mentorship continues to impact countless young physicians, students, and allied medical personnel. With flawless judgment, he led colleagues from Europe and beyond in the steady professional development of facial plastic surgery. I have never encountered anyone with better medical judgment.

Tony Bull (1934–2016).

Tony Bull exhibited versatility as a very young student in boarding school, excelling academically and athletically, particularly in hockey and tennis, at a high competitive level. His father, a dentist, encouraged him to pursue a medical career, and we all are much the better for his having agreed to that plan. His training at the London Hospital and the Royal National Throat, Nose and Ear Hospital prepared him well for a career that bridged academia and private practice. In short order, he attained the highest of appointments in Britain and established a sterling reputation as a much sought-after teacher and surgeon of excellence. His Color Atlas of ENT Diagnosis, published in 1974, remains a favorite bestseller today worldwide.

His medical accolades would fill more space than allotted here, but it shall be left to others to tell that story. Instead, I wish to characterize Tony Bull the man, friend, husband, father, teacher, visionary, orator, and, not unimportantly, the humorist whose message and stories inspired and entertained while underscoring lessons to be learned. His lectures were highly sought after, attended, and raptly absorbed: no one dosed off while in his audience. He taught by anecdote, never failing to leave a lasting imprint on eager listeners. Today, and tomorrow for the foreseeable future, his stories will be repeated with a chuckle and with gratitude.

My first encounter with Tony was by chance: he visited “the colonies” to learn more about the work of John Shea in stapedectomy.

Ah, Taardy … how goes the battle in the colonies?

From that exposure to the fertile mind of Dr. Shea, a publication developed regarding the role and importance of the chorda tympani during stapedectomy. It may not be well recognized that Mr. Bull, in addition to his international expertise in rhinoplasty, performed stapedectomy until very recently and enjoyed a sterling reputation for otologic excellence. He mastered the operating microscope and early on adapted it for televised demonstrations of intranasal surgery. He was drawn to the artistic nature of rhinoplasty, and by extension facial plastic surgery, as it blossomed and developed in the 1970s. Travels to New York to learn from Irving Goldman resulted in a lifelong dedication to the value of the Goldman tip in nasal surgery. Tony was intrigued early along by the pioneering dedication to education and excellence of the American Academy of Facial Plastic and Reconstructive Surgery, and in tandem with Claus Walter of Germany, set about to organize and establish the professional nature of the European Academy of Facial Plastic Surgery (the Joseph Society). He lectured and taught tirelessly throughout the capitals and countries of Europe (frequently at his own expense), establishing a dedication to excellence that was infectious. How ironic it seemed to those of us who regarded him so highly as an educator that in midcareer, an idiopathic vocal cord paralysis surfaced that substantially altered, but could not still, his vibrant messages. He soldiered on, standing closer to the microphone. In time, his iconic voice improved.

“I have not returned from Africa undiseased, frequently passing purple iridescent urine …”

Fig. 1 Tony Bull operating at the Kopf Klinik at the University of Wurzburg, Germany, during a joint course of the AAFPRS and EAFPS, 1974.

With the skill of a practiced diplomat, he blended colleagues from the varying medical systems of Europe into a professionally cohesive, educational, and proud society that continues to grow today, based on education and excellence. It is doubtful any other man could have accomplished this feat, given the varying and diverse medical educational systems and certifications throughout Europe.

“Our European dilemmas sometimes stretch my vast fund of good humor, requiring a serious flex of my cortex.”

Tony is the cofounder of the pioneering journal Facial Plastic Surgery which continues to flourish in Europe and the United States today.

As a schoolboy boxer, his admiration for the sport never diminished, and he could recite chapter and verse regarding all prominent boxing champions. Such was his dedication that it was not uncommon for him to fly to a Las Vegas fight venue overnight, returning to his obligations in London immediately after the verdict had been reached. His strong forearms served him well on the golfing links, where, sporting an enviable handicap, he regularly recorded quite respectable scores. And almost without fail, his “golfing costume” of choice never failed to include a short-sleeved blue shirt adorned by his ubiquitous gravy-stained university tie, capped by tailored blue slacks. He played the ball as it lies, and regularly complimented his opponent on the “majesty of your swing.”

We shared a love of tennis and for years enjoyed spirited “knock-ups” in London and Naples, Florida, capped by fierce competition on the magnificent Wimbledon-inspired grass court he erected at his country home, Sarsgrove. Until only recently, when a weakened heart slowed his endurance, he demonstrated the schooled classic strokes of a polished competitor.

Fig. 2 “The proper grip, Taardy, makes all the D in the W” (difference in the world).”

Tony's devotion to his wife Jill, a nurse and champion golfer, and to his son Anthony and daughters Amanda and Karen could not have been more intense. They shared a strong family bond and love, strengthened by the arrival of six lovely granddaughters. With a mischievous chuckle, he would fondly refer to the girls as “my little tartlets.”

Words and accolades at times like these, whether written, spoken, or sung, seem to be inadequate and without the weight they require that the person deserves. Medicine mourns one of its finest practitioners, one who understood compassion and communication better than almost all others. He pursued excellence in himself and his house officers, and I personally never heard him speak ill of another physician or a competing specialty, but as Ian McKay, his close friend, remarks: “He could appropriately spot humbug when he saw it.” Innumerable honors and awards gravitated his way during his career, all richly deserved.

Fig. 3 “It's a hard life …”

Tony Bull uniquely impacted his medical specialty, deeply loved his family, made his house officers and colleagues better physicians, and rewarded his friends with stories filled with humor that only he could deliver properly. His strong sense of noblesse oblige will remain in all who were privileged to know him.

I choose not to be saddened by his loss, but rather to adopt the philosophy offered by James Whitcomb Riley:

-James Whitcomb Riley (1849–1916)

He is Just Away

I cannot say, I will not say

That he is dead. He is just away!

With a cheery smile

And a wave of the hand

He has wandered into an unknown land

And left us dreaming how very fair

It needs must be,

Since he lingers there;

So think of him faring on, as dear

In the love of There as the love of Here

Think of him still

As the same, and say

He is not dead, he is just away

– Gene Tardy, MD, FACS

Emeritus Professor

University of Illinois Medical Center

Chicago, IL

The sad news about the sudden death of Tony Bull has us deeply touched and shocked. Since I have lost a very dear friend and respected colleague, I would like to share my memories with Tony Bull with you.

In the early seventies, I was introduced to Tony Bull by a colleague, Air Vice-Marshal Manus Morau, at the British Air Force Base at Wegberg. In those days, Tony Bull had already built up a special reputation as a stapes surgeon in London at the Royal National Throat, Nose and Ear Hospital. In this university hospital, Tony had later held his very well-known courses for Facial Plastic and Reconstructive Surgery for the European Academy.

When I first met Tony, I realized quickly that he wanted to follow the philosophy of the American Academy of Facial Plastic and Reconstructive Surgery. We both decided to devote part of our time and work together occasionally in London or Düsseldorf to follow the shiny example of the American Academy. These common meetings enabled us to get in touch with colleagues from all over Europe who were interested to join us in a European Society. This, finally, led to the inauguration of the Joseph Society. Tony Bull was responsible for the organization of the first congress in London in which we had the magnificent banquet in the historical Apothecaries' Hall.

The acorn we have planted with Tony's help has grown in the meantime to a mighty oak tree starting with approximately 20 members to around 1,000 now.

Unfortunately Tony left his family, his friends, and his professional colleagues too early.

He deserves a special honor from the Academy for his personality, his world-renowned name as a rhinoplasty surgeon, and his so important help to the European Academy.

I will miss him forever.

– Claus Walter

Teufen, Switzerland

Tony Bull was a great person. I learned so many personal and professional things from him. It was a privilege to take over the torch as president of the European Academy of Facial Plastic surgery (his baby) from him.

On a personal basis, I enjoyed his company and humor as he said I tried to kill him twice, once with a Havana cigar after his vocal cord paralysis and during a snorkeling trip in Cancun, drowning him. He insisted to give his traditional lecture at our Rhinoplasty Course in October last year, out of breath due to his heart problems, and I was able to pour him the best wine from my cellar during the course dinner.

I will miss him!

– Gilbert Nolst Trenite, MD

Amsterdam, NL

Too many tributes to Tony Bull were sent to publish all of them. A selection is provided here:

Very sad news for those of us who knew him and for the IFFPSS. I remember his talks at the first meeting of the IFFPSS in Cancun and at the international symposium in London, where I had the honor of listening to his ideas during a very enjoyable and unforgettable dinner.

– Jose Juan Montes Bracchini

The sad passing of a colleague, mentor, and one of the early leaders and visionaries of facial plastic surgery. May he rest in peace and comfort.

Fig. 4 Tony Bull with Rhonda and Regan Thomas.

–Fred Fedok

Tony was a long time great friend, travel companion, and like for all of us, insightful mentor. My whole family has so many wonderful memories of being with Tony and Jill. His unique sense of humor was coupled with a genuine sense of style and class. I will always be grateful …

– J. Regan Thomas

Tony was a warm and wonderful friend, and a colorful and meaningful figure in the realm of European and International Facial Plastic Surgery.

Fig. 5 (Left to right) Drs. Papel, Tardy, Toriumi, and Bull, 2005.

– Roger Crumley

Tony's distinct voice, and familiar expressions, will remain with me for as long as I live. He was an innovative, talented surgeon with a great sense of fun. Most of all he was a trusted colleague and true friend. We will all miss his presence in the future.

A photo from 2005, when Tony, Gene, Dean, and I were the visiting faculty for a rhinoplasty course in Porto, Portugal. Tony was an accomplished golfer and loved to work in a game at any course possible. Gene, of course, was his most frequent partner but I had the chance to join in from time to time. Scenes like these really sum up the type of person Tony was: warm, engaging, fun, and full of life.

– Ira Papel

I saw him at a meeting in Utrecht last fall. He gave what he said would be his last lecture at that meeting. He was as funny and insightful as ever. He was with his daughter who accompanied him to Holland. He was a true giant in our field and one of my heroes. In my early recollections, he gave an elegant and sophisticated image to the nascent field Facial Plastic Surgery. His wit, his poise, his craftsmanship, his unforgettable character—there will never be another Tony Bull. I feel fortunate that I was able to say goodbye one last time.

– Norman Pastorek

A huge loss for our specialty—a very classy colleague.

– Peter Hilger

Sadly missed but never forgotten. An inspiration to us all at home and abroad.

–Julian Rowe-Jones

Tony Bull (TRB as we all knew him) will be remembered by many as one of the great contributors to the development of modern ENT. He was by nature a very British voyager who made it a point to travel and visit to learn from best of the best and not only in Europe but also North America—a pioneer of international collaboration that we take for granted now. He was a talented surgeon appointed at a young age with an astute judge of character and an uncanny ability to charmingly test people without them knowing they were the subject of his humor and wit. Those who have seen his video “Don't Mention the War” on otoplasty will understand this.

Fig. 6 Tony Bull from the video “Don't Mention the War,” 1997.

His drive to produce the best teaching environment for his passion in rhinoplasty and facial plastic surgery produced one of the most successful and long running courses at the Institute of Laryngology and Otology in London and educated a generation and a half of budding surgeons nationally and internationally. At times, although he showed occasional insecurity or a self-deprecating position, he was most definitely his own man. He created the Joseph Society (subsequently the European Academy of Facial Plastic Surgery) with another of Europe's great surgeons, Professor Claus Walter, whom he allied to the American Academy of Facial Plastic and Reconstructive Surgery and was responsible for setting up the first certification in Europe in what became a new discipline in surgery.

Of course, his contributions to surgery have been recognized and honored around the world and many are grateful to have had his friendship, encouragement, and mentoring, not to mention his particular sense of humor and entertaining nature. He was also passionate about boxing, horses, tennis, and cricket amongst other sports, enjoying a life outside medicine.

All who knew him have been touched with a sad feeling of loss; however, his legacy lives on through those he inspired.

– Charles East, London

Today the House of Facial Plastic Surgery mourns the loss of a respected colleague. In Tony Bull's mind, it was never about him. It was about the better good. His is a legacy to which we should all aspire.

Fig. 7 London, 2014.

–Gaylon McCollough

A sad day for all of Facial Plastic Surgery. Tony was truly a great one in our field of endeavor. A teacher, a mentor, and a friend to all. A man of good humor, wonderful intellect, and marvelous surgical skills. A physician with accomplishments and abilities to be admired. A good doctor.

– Bill Truswell

I did not know Tony Bull like others on this list, but loved hearing him speak for his to-the-point commentaries and his insights. One of the greats from the other side of the pond who helped put facial plastic surgery on the map.

– Minas Constantinides

Tony Bull's passing is a loss for all of facial plastic surgery. We'll all miss him.

– Paul Carniol

I am very sad, Tony is ONE of the giants in facial plastic surgery, a tremendous teacher, and leader.

We are going to miss him!!

– Jaime Fandino

I am truly saddened to hear of Tony's death. My sincere condolences go out to his beloved Jill and the Bull family. Tony was more than just a colleague and friend. In many ways, he was my British kindred spirit. I will recall when Tony and I met as students in New York City at Irving Goldman's Rhinoplasty course in 1965. We went on to share a lifetime interest in nasal surgery and never quite understood why so few others did not embrace the value of the Goldman technique and the advantages of vertical dome division. Tony was a true pioneer and leader in the facial plastic surgery movement abroad. He inspired so many with his knowledge and unique, wry wit. He will be sorely missed.

– Bob Simons

I remember Dr Tony Bull very well during my short stint of fellowship with him for approximate just under 2 months at his office in Harley Street and King Edward VII Hospital. It was during the winter period of his career and he was very much a generous teacher, superb surgeon and clinician, full of humor and wit and love of cricket.

– Tuan V. Pham

He was indeed a great leader and mentor in our field. The comments on this email trail are indeed a noble tribute to the man and his many contributions.

Fig. 8 Royal College of Surgeons, London, 2014.

Fig. 9 Tony Bull with Drs. Domenico Minghetti, Sebastiano Sciuto, Pietro Palma and Russ Kridel (Verona, Italy, 2009).

–Bob Kellman

For everyone who knew Tony well, or even those who had only met him once, you will immediately have the sense that we have just lost one of our international leaders in facial plastic surgery and a magnificent man. Tony will perhaps be best remembered for his marvelously entertaining presentations on rhinoplasty. They were always filled with a sense of humor, sly asides, and irreverent remarks. However, these engaging witticisms merely served to magnify his deep understanding and mastery of the procedure he so loved. It was always a delight to hear Tony at the podium, but even better to know him as a friend. He was a joyful, opinionated, and insightful conversationalist. He was generous and caring in spirit.

Tony's most significant professional legacy, in addition to his tremendous contribution to our knowledge of and the teaching of rhinoplasty, was undoubtedly his pioneering the creation of The Joseph Society along with Claus Walter, this ultimately becoming today's European Academy of Facial Plastic and Reconstructive Surgery. Each and every one of us owes a debt of gratitude to Tony for his leadership in establishing facial plastic surgery as a specialty in Europe.

Tony was a giant of a man, professionally, personally, and now in spirit. We shall miss him.

Peter Adamson