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Interview Dr Nicolas Zwillinger

Interview with Dr Nicolas Zwillinger


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Doctor Zwillinger, a leading French specialist in lipedema, tells us about his career and the reasons that led him to take an interest in this still little-known disease.

Hello, could you tell us what your job is?

It is a profession that can change every day, but its specificity remains its technicality. We offer surgical solutions to aesthetic concerns or those linked to malformations. There are no “rules”: whether these defects are visible or not, what counts is that they give patients complexes.

These defects can therefore be out of the ordinary (asymmetries, hypertrophies, losses, excesses) or cause concern, even if they are not abnormal, because they do not fit into the patients’ aesthetic framework – into their criteria of beauty.
I tend to see my job as that of a body repairer: when people suffer from their appearance and need help, they call on me to change aspects of their body – a bit like car parts, if I may say so.

So it’s primarily a very manual job – in fact, more technical than scientific. That’s why it’s important to be up to date with the latest innovations.

What made you decide to become a surgeon?

What really triggered my interest in the profession was when I saw a documentary about the daily life of surgeons. I was about 8 years old. It was love at first sight.

I remember thinking that it was incredible to work on living matter, to discover the hidden aspect of the human body. It was another world that opened up to me: I felt like Alice in Wonderland.

This work on the body led to another eminently mysterious question: what exactly is life?

For me, understanding the mechanism of the body (again, a bit like a car!) is already the first answer to this question.

And of course, there is the aspect of repair behind it: it is not a neutral discovery of the human body: it is an act that will repair the body, and which will therefore be extremely beneficial.

I also loved playing Dr. Evil, maybe that’s where it all comes from!

What did you study to become a surgeon?

I began my studies in medical school, between 1992 and 1994. After these first years, I went to the Political Science preparatory course, another field that attracted me a lot – and that seemed less theoretical and cold than medicine. In the end, I missed it and quickly returned to it.

I did 6 years of medicine – but with the aim of becoming a surgeon, with another 6 years of study necessary to specialise. As I had done quite well in my internship exams, I was able to stay in Paris and operate in the surgical departments.

Why did you choose to specialise in the treatment of lipedema?

What I wanted to do initially was to help people overcome their complexes. I soon became interested in fat tissue. At the time, we were talking about fat transfer – what we call lipofilling. This led me to work on stem cells: the fascinating thing about fat cells is that they can produce different types of growth. They can help repair the body. Simply put, fat cells are mini-surgeons.

So I got a BodyJet in 2012: it’s an incredible machine that transfers fat in a very safe way. It’s actually very useful for the treatment of lipedema. Gradually, patients came to me with this problem, knowing that I had this expertise.

So I started to work a lot on Liposuction WAL, which is both very aesthetic and functional. What particularly excited me was that it is a surgery that goes beyond appearances and other “ordinary” complexes. It is a surgery that can actually reduce physical suffering, which is a novelty in the genre.

Can you tell us about th liposuction WAL technique, which you pioneered in France?

The term stands for “Water Assisted Liposuction”. It works a bit like a Karcher method: as if a lot of water was going to clean the wall under pressure. In fact, the water here will be “injected” into the “diseased” fat, and will make it move with the suction. This is a very effective method, but it is still not widely used in France. Few surgeons have invested in this technology.

What do you love about being a surgeon?

It’s an adventure, a challenge, which involves a lot of questioning, learning every day, and constant discovery. You have to adapt to all sorts of new techniques.

There is also a lesser known aspect, that of teamwork. You learn every day from your colleagues: there is an aspect of collegial work, where you are inspired by others.

Finally, what also motivates me is the concentration, the finesse, the precision that the work requires. I have to surpass myself, day after day.

Dr. Nicolas Zwillinger what do you think are the disadvantages of this job?

Well, if I had to choose a disadvantage: you can’t hold a grudge.
What I mean by that is that surgery is difficult to do, long and painful operations. They are stressful: sometimes there are abnormalities, but of course you can never give up. You have to find a solution, whatever it takes, right away.

You have to be physically and mentally strong not to break down during these operations – which are performed on a living being who trusts you, let’s not forget!

Therefore, as soon as you leave the operating theatre, you must be able to forget these moments. You must only retain the satisfaction, the sense of duty accomplished, and be ready to go back the next day. Pressure must be completely managed – it must never become harmful for the patient.

What advice would you give to a student wishing to become a surgeon?

I would advise him to be sure that he can accept the above mentioned disadvantages. He must also be willing to work with blood – because he will see a lot of it, and sometimes have it on him.
If he feels that his motivation is strong, that he has a desire to test himself every day, then he should not give up. Let him keep in mind the goal of doing his duty – it’s long, it’s tedious, but it’s incredibly rewarding.

And in any case, it will require a combination of determination, courage, and character. This will help him to be as effective and healthy as possible in his approach to work.

To close this interview with Dr Nicolas Zwillinger, would you like to say a final word?

To discuss your lipedema or any other surgical project, I invite you to make an appointment…

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