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Augmentation mammoplasty
102
BRITISH
JOURNAL
OF PLASTIC
SURGERY
dealing with all major clinical problems including organ transplantation and chemotherapy. Each chapter deals separately with procedures relating to a particular speciality and follows the same format, that is, a short uncomplicated description of the clinical problem, diagnosis, surgical treatment and nursing care pre- and postoperatively. There is much necessary emphasis placed in the initial chapter on the psychological needs of the child and his parents, and this emphasis is perhaps unnecessarily belaboured in subsequent chapters. The illustrations in the book are of poor quality and a few are so complicated as to serve no useful purpose. The text is clear, concise and easy to follow. Though this book is recommended for the use of the nurse experienced in paediatric surgical nursing, some of the content is over-simplified and would appear to be directed more to the nurse in the learning situation. Bearing in mind that this is a text book with American terminology and procedures, the experienced nurse should find this book a valuable source of reference. A. M. BROWNING R.G.N., R.S.C.N.
PLASTIC AND RECONSTRUCTIVE SURGERY OF THE BREAST. Edited by ROBERT M. GOLDWYN. gi $4 with 465 illustrations. (Boston: Little, Brown and Company, 1976)~ Price
.
.
This outstanding work will remain the definitive treatise in its field for some years. The editor has persuaded most of the originators of mammaplasty techniques, who are still alive, to write a chapter on his or her method. Thus, in the section on reduction marnmaplasty and ptosis, which occupies one-third of the book, we have chapters by the well-known names which are bandied about whenever z or more plastic surgical trainees are gathered together: Strombeck, McKissock, Weiner, Penn, Pitanguy, Dufourmentel and Mouly, Regnault, and Go&an. At the end of each chapter there is a “comment” by another author. This device might have led to keen criticism but in fact the writer of each comment is usually one who is a devotee of the technique on which he is commenting. This serves to bring out additional points and suggest modifications, but criticism on the whole is muted. Apart from the initial section on “background” which deals with history, anatomy, physiology, pathology and psychiatry, the other sections are similarly arranged with the authoritative article followed Every aspect of breast surgery is covered, including a thoughtful article on breast cancer by a “comment”. by a surgical oncologist, Dr R. E. Wilson. Plastic surgical techniques and their modifications in breast surgery are legion. This is usually taken to mean that none is wholly satisfactory. There is no doubt some truth in this but I am sure that the main reason is that elastic sureeons have so far failed to define the nroblem. The individualitv of human breasts is as unique as their owner’s chromosomes and yet our attempts to classify them are ludi-crously inadequate and little more than big, small and ptotic. Operations which are ideal for one shape of breast are pushed beyond their limit in others. Surely the next-advance in reconstructive breast surgery is the classification of the deformities involved. It is a difficult problem since it is 3-dimensional and few of us think well in more than 2 and for this reason our approach has been empirical rather than precise. We must also define and classify the results we want to achieve. Postoperative resuhs of breast plastic surgery are always shown with the patient erect; her breasts should be just as aesthetically pleasing, if not more so, when she lies down. Although this volume does not always give the answer about what one should do in the individual case, it is a rich compendium of nearly all the information on its subject so far available in the West. T. GIBSON
AUGMENTATION MAMMOPLASTY. By A. RICHARD GROSSMAN. Pp. 92.
Thomas,
1976).
(Springfield:
Charles C.
Price $14.50.
To anyone who knows that none of the declension of the Latin mamma ends in 0; the spelling “mammoplasty” irritates; but there is precedence in “mammography” which has been accepted for many years. When the reviewer recovered from his initial irritation, he found this little book well written, well illustrated and offering sound advice. It is not on the grand scale of Goldwyn’s edited volume. According to the blurb it is not designed for the plastic surgeon already well versed in augmentation mammaplasty; “it is a text for the surgical resident both in general and plastic surgery and for the general surgeon who may not be as well versed in this procedure as some of his plastic surgeon contemporaries”. For this purpose it is adequate, covering not only the augmentation of the small breast but replacement of breast tissue after subcutaneous mastectomy for which it seems the American female is clamouring increasingly. He discusses fully the complications of breast implants but it is obvious that he selects his cases with care. Thus there is no mention of the ptotic breast in which a mastopexy must be combined with the implantation of a prosthesis. With the many different sizes and shapes of breast prostheses now appearing on the market, one would have appreciated more guidance on when to use a tear drop, when a round, and how many cc’s in the different shapes of breast. The author is against the Dacron patches of the original Cronin prosthesis believing that they increase capsule formation and by adhering to the pectoral fascia remain too high as the breast tissue descends with age. His preference would appear to be for the Heyer-Schulte inflatable model inserted through a periareolar incision. T. GIBSON
BRITISH
JOURNAL
OF PLASTIC
SURGERY
dealing with all major clinical problems including organ transplantation and chemotherapy. Each chapter deals separately with procedures relating to a particular speciality and follows the same format, that is, a short uncomplicated description of the clinical problem, diagnosis, surgical treatment and nursing care pre- and postoperatively. There is much necessary emphasis placed in the initial chapter on the psychological needs of the child and his parents, and this emphasis is perhaps unnecessarily belaboured in subsequent chapters. The illustrations in the book are of poor quality and a few are so complicated as to serve no useful purpose. The text is clear, concise and easy to follow. Though this book is recommended for the use of the nurse experienced in paediatric surgical nursing, some of the content is over-simplified and would appear to be directed more to the nurse in the learning situation. Bearing in mind that this is a text book with American terminology and procedures, the experienced nurse should find this book a valuable source of reference. A. M. BROWNING R.G.N., R.S.C.N.
PLASTIC AND RECONSTRUCTIVE SURGERY OF THE BREAST. Edited by ROBERT M. GOLDWYN. gi $4 with 465 illustrations. (Boston: Little, Brown and Company, 1976)~ Price
.
.
This outstanding work will remain the definitive treatise in its field for some years. The editor has persuaded most of the originators of mammaplasty techniques, who are still alive, to write a chapter on his or her method. Thus, in the section on reduction marnmaplasty and ptosis, which occupies one-third of the book, we have chapters by the well-known names which are bandied about whenever z or more plastic surgical trainees are gathered together: Strombeck, McKissock, Weiner, Penn, Pitanguy, Dufourmentel and Mouly, Regnault, and Go&an. At the end of each chapter there is a “comment” by another author. This device might have led to keen criticism but in fact the writer of each comment is usually one who is a devotee of the technique on which he is commenting. This serves to bring out additional points and suggest modifications, but criticism on the whole is muted. Apart from the initial section on “background” which deals with history, anatomy, physiology, pathology and psychiatry, the other sections are similarly arranged with the authoritative article followed Every aspect of breast surgery is covered, including a thoughtful article on breast cancer by a “comment”. by a surgical oncologist, Dr R. E. Wilson. Plastic surgical techniques and their modifications in breast surgery are legion. This is usually taken to mean that none is wholly satisfactory. There is no doubt some truth in this but I am sure that the main reason is that elastic sureeons have so far failed to define the nroblem. The individualitv of human breasts is as unique as their owner’s chromosomes and yet our attempts to classify them are ludi-crously inadequate and little more than big, small and ptotic. Operations which are ideal for one shape of breast are pushed beyond their limit in others. Surely the next-advance in reconstructive breast surgery is the classification of the deformities involved. It is a difficult problem since it is 3-dimensional and few of us think well in more than 2 and for this reason our approach has been empirical rather than precise. We must also define and classify the results we want to achieve. Postoperative resuhs of breast plastic surgery are always shown with the patient erect; her breasts should be just as aesthetically pleasing, if not more so, when she lies down. Although this volume does not always give the answer about what one should do in the individual case, it is a rich compendium of nearly all the information on its subject so far available in the West. T. GIBSON
AUGMENTATION MAMMOPLASTY. By A. RICHARD GROSSMAN. Pp. 92.
Thomas,
1976).
(Springfield:
Charles C.
Price $14.50.
To anyone who knows that none of the declension of the Latin mamma ends in 0; the spelling “mammoplasty” irritates; but there is precedence in “mammography” which has been accepted for many years. When the reviewer recovered from his initial irritation, he found this little book well written, well illustrated and offering sound advice. It is not on the grand scale of Goldwyn’s edited volume. According to the blurb it is not designed for the plastic surgeon already well versed in augmentation mammaplasty; “it is a text for the surgical resident both in general and plastic surgery and for the general surgeon who may not be as well versed in this procedure as some of his plastic surgeon contemporaries”. For this purpose it is adequate, covering not only the augmentation of the small breast but replacement of breast tissue after subcutaneous mastectomy for which it seems the American female is clamouring increasingly. He discusses fully the complications of breast implants but it is obvious that he selects his cases with care. Thus there is no mention of the ptotic breast in which a mastopexy must be combined with the implantation of a prosthesis. With the many different sizes and shapes of breast prostheses now appearing on the market, one would have appreciated more guidance on when to use a tear drop, when a round, and how many cc’s in the different shapes of breast. The author is against the Dacron patches of the original Cronin prosthesis believing that they increase capsule formation and by adhering to the pectoral fascia remain too high as the breast tissue descends with age. His preference would appear to be for the Heyer-Schulte inflatable model inserted through a periareolar incision. T. GIBSON