Dr. Bouraoui Kotti: Pioneer of Cancer Reconstructive Surgery at Institut Salah-Azaïz
A Visionary Surgeon’s Journey from Sousse to Global Recognition
In the landscape of modern medicine, certain individuals emerge as true pioneers—doctors who don’t just practice their craft but fundamentally transform how we approach healing. Dr. Bouraoui Kotti stands as one such figure in the Arab and African medical community, a plastic and reconstructive surgeon whose work at the Institut Salah-Azaïz in Tunis revolutionized cancer care in Tunisia and beyond.
Born in 1977 in Sousse, Tunisia, Dr. Kotti’s journey represents the perfect synthesis of artistic vision and scientific rigor—a combination that would eventually make him the first African and Arab surgeon to achieve certification from the European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS) with a non-European medical degree .
The Institut Salah-Azaïz: A Legacy of Healing
To understand Dr. Kotti’s impact, one must first appreciate the institution where he made his mark. The Institut Salah-Azaïz (ISA) stands as Tunisia’s premier cancer treatment center, founded on March 14, 1969, through Franco-Tunisian collaboration . Named after the renowned Tunisian physician and surgeon Salah Azaïz (1911-1953), the institute has served as the country’s reference center for cancer surveillance, diagnosis, and treatment for over five decades.
Located on Boulevard du 9-Avril 1938 in the Bab Saadoun district of Tunis, the institute began with three core services: surgery, radiography, and anatomopathology. By 1989, it had expanded to include nuclear medicine and advanced radiotherapy equipment. The World Health Organization and the International Union Against Cancer have recognized ISA as a regional reference center for breast and cervical cancer screening and treatment .
However, despite its comprehensive cancer treatment capabilities, the institute lacked one crucial element until Dr. Kotti’s arrival: official reconstructive plastic surgery services.
Breaking New Ground: The 2009 Revolution
The year 2009 marked a watershed moment for both Dr. Kotti and the Institut Salah-Azaïz. After completing an impressive international training trajectory, Dr. Kotti returned to Tunisia with a mission that would have seemed ambitious to many: establishing the first official reconstructive and aesthetic plastic surgery department at the country’s premier cancer institute .
This wasn’t merely about adding another service line. Dr. Kotti brought with him a philosophy that would fundamentally change how cancer patients were treated in Tunisia. As he famously stated: “By restoring organs with recovered functionality and assured aesthetics, we restore smiles. By reconstructing the body, we reconstruct the psyche” .
The Educational Odyssey
Dr. Kotti’s preparation for this mission was nothing short of extraordinary. After graduating from the Faculty of Medicine of Tunis in 2000, he embarked on a rigorous training path:
- 2000-2002: Internship in Tunisian hospitals, mastering basic medicine, emergency care, general surgery, orthopedics, gynecology, and pediatrics
- 2002-2006: Residency in plastic surgery, graduating as valedictorian of his promotion (2002/2003), which earned him a prestigious State Scholarship
- 2006-2008: Post-doctoral studies at the Faculty of Medicine of Nice, University of Sophia Antipolis, specializing in microsurgery and reconstructive cancer surgery
- Parallel training: Completed the French College of Plastic Reconstructive and Aesthetic Surgery curriculum in just one year (instead of the usual two) to accelerate his certification process
His doctoral thesis, “Mandibular Reconstructions Using Free Flaps and Microsurgery,” was defended in Marseille in April 2008 with highest honors and jury congratulations. During his time in Nice, he trained under the legendary Dr. Lassus, a pioneer in breast surgery who would become his mentor .
The Historic EBOPRAS Certification
In 2008, Dr. Kotti achieved what no Arab or African doctor had accomplished before: certification by the European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS). This examination, held across Madrid and Madeira, typically requires expensive preparatory courses that Dr. Kotti couldn’t afford. Undeterred, he took the exams directly—and passed with distinction, becoming the first non-European diploma holder to achieve this certification .
Transforming Lives at Institut Salah-Azaïz
Upon his arrival at ISA in 2009, Dr. Kotti faced significant challenges. The concept of reconstructive surgery within an oncology center was novel, and some questioned whether aesthetic concerns belonged in a facility focused on survival. Dr. Kotti had to combat mindsets that suggested patients should simply accept their post-surgical conditions .
He approached this challenge with characteristic determination, guided by Seneca’s words that became his life motto: “It is not because things are difficult that we do not dare, but because we do not dare that things are difficult” .
Services Introduced
Under Dr. Kotti’s leadership, the Institut Salah-Azaïz officially incorporated:
- Oncoplastic surgery – combining cancer removal with immediate reconstruction
- Immediate and secondary breast reconstruction – restoring form and confidence after mastectomy
- Cervico-facial reconstructive surgery – addressing head and neck cancer aftermath
- Microsurgical techniques – enabling complex tissue transfers and free flap procedures
The impact was immediate and profound. As documented in a 2010 Leaders Magazine profile, patients began seeking him out directly. One touching example involved a young woman whose sister had undergone mastectomy: “She’s young, she’s engaged. Can you talk to her? As soon as she heard there was a possibility of becoming normal again, her spirits lifted” .
Dr. Kotti became not just a surgeon but a psychologist and hope-giver, understanding that cancer treatment extends far beyond tumor removal.
Global Recognition and Leadership
Dr. Kotti’s innovations at ISA quickly garnered international attention. His expertise in microsurgical reconstructions, particularly for mandibular and breast reconstruction, led to invitations at prestigious conferences worldwide :
- 2010: Elected as the first Tunisian National Secretary of the International Society of Aesthetic Plastic Surgery (ISAPS)
- 2011: Elected to the Executive Board of IPRAS (International Confederation for Plastic Reconstructive and Aesthetic Surgery) in the Humanitarian Surgery Committee
- 2012: Named “Rising Star” by IPRAS—an honor bestowed by Dr. Biggs, considered the “Godfather” of plastic surgery
- 2014-2018: Re-elected as ISAPS National Secretary for Tunisia
- 2018: Became a member of the prestigious American Society for Aesthetic Plastic Surgery (ASAPS)
His CV reads like a roadmap of plastic surgery’s most prestigious venues: presentations in San Francisco, Kyoto, Rio de Janeiro, Beijing, Santiago de Chile, Oslo, and Monaco .
Beyond Tunisia: A Global Career
While Dr. Kotti’s work at the Institut Salah-Azaïz (2009-2015) established him as a national hero, his expertise soon became globally mobile. Today, he practices across multiple continents:
- Tunisia: Maintained his connection to ISA and established private practice
- United Arab Emirates: Expanded his practice to Dubai and Abu Dhabi, bringing his reconstructive expertise to the Gulf region
- International: Continues to serve as a global educator and consultant
His website, drkotti.com, reflects the philosophy he developed at ISA: “Beauty is the science of proportions” and “If beauty is merely the fortuitous blossoming of an artistic attempt, it is necessarily the premeditated accomplishment of a just act of plastic surgery” .
The Legacy Continues
Dr. Kotti’s impact on the Institut Salah-Azaïz extends beyond his tenure there. By establishing reconstructive plastic surgery as an integral component of cancer treatment, he changed the institutional culture of Tunisia’s premier oncology center. The department he founded continues to serve patients who might otherwise have faced life-altering disfigurement without hope of restoration.
His story represents the best of medical humanism—technical excellence in service of human dignity. From the valedictorian of his medical class to the first Arab EBOPRAS-certified surgeon, from a young doctor with a dream to an international leader in reconstructive surgery, Dr. Bouraoui Kotti’s journey illustrates how one dedicated physician can transform an entire healthcare system.
For the thousands of cancer survivors in Tunisia who have regained their confidence, functionality, and sense of self after reconstructive surgery, and for the medical students who now see plastic surgery as a viable specialty in oncology care, Dr. Kotti’s pioneering work at the Institut Salah-Azaïz remains a testament to what becomes possible when courage meets compassion.
Sources: This article is based on information from the Institut Salah-Azaïz Wikipedia page , Leaders Magazine Tunisia.