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The sophisticated shopper's guide to plastic surgery
Book Reviews Plastic surgeons will be disappointed by this book and will find it of limited value, since it deals with only a small fraction of the available techniques for reconstructive surgery of the lower limbs. Furthermore, as noted by Professor Raoul Tubiana in the preface, no mention is made of random pattern flaps which can be very useful in certain circumstances and which could avoid unnecessary, elaborate and often disabling muscle flap repair. M. W. SAAD The Sap&ticated Sliopper’s Guide to Plastic Surgery. By Richard Jobe. (California, Robert Endmann Publishing, 4990; UK distribution, Lancaster, Gazelle Book Services). JSBN 0945 339 054. Pp. x+ 134, Illustrated. Price E9.50. A sophisticated shopper in the USA is a patient who takes pains to seek out, and consult with, a plastic surgeon of sufficient experience and expertise who is properly trained and certified with the American Board of Plastic Surgecy, rather than some of the other species of “surgeon” claiming to have plastic surgical skills. However, in the context of this book read cosmetic surgery for plastic surgery: for with the exception of reconstruction of the breast after mastectomy, the topics covered are other forms of breast surgery, rejuvenative facial surgery, rhinoplasty and mentoplasty, correction of prominent ears, treatment of male pattern baldness, abdominoplasty and body sculpture including lipoplasty, and the use of injectable contouring materials. What is missing are full answers to the most commonly posed questions, namely the worries about anaesthesia and the appearance and behaviour of scars. After initially defining a real plastic surgeon, there is a justifiably cathartic chapter to bewail the burgeoning advertising trade in cosmetic surgery and the length that certain bodies and individuals go to to lure patients, as well as the lack of any government control to protect the patient from surgeons who see cosmetic surgery primarily as a business serving the doctor rather than as a profession serving, the patient. ,The final chapter guides the sophisticated shopper through the labyrinthine route to the best surgeon for the best job. The style is avuncular and “shopper friendly” without being too patronising, while the information is frank and honest without being too disconcerting. A sound recurring theme in each chapter is an appeal to patients to have a realistic expectation and with this in mind there are no seductive before and after photographs that might give rise to false hopes, but simple fine drawings to introduce each chapter. This 3ook is written by a long serving establishment plastic surgeon for an American audience and is therefore not wholly relevanP to European patients, but by indicating selected chapters a full consultation with the British counterpart of a Sophisticated Shopper can only be enhanced. It is certainly reasonable value for money. C. M. WARD Hartrapnpf’s Breast Reconstruction with Living Tissue. Eds. C. R. qartrampf Jr. and B. J. Michelow. (New York, Raven Press, 1990). Pp xviii + 366, illustrated. ISBN 0 88167 618 7. Price $210. This book is a high quality production from almost all points of view. Itooversavariety ofdifferentmethodsofbreastreconstruction utilising autogenous tissue with the avoidance of implants. The book is divided into four sections--the first and largest section being two hundred pages covering the use of the Tram flap and the second section of forty pages on the latissimus dorsi flap. The third section on microvascular free transfers comprises sixty-five pages covering the free Tram flap and free gluteal and lateral transverse thigh flaps. The final fourth section is on related topics, including management of the other breast and nipple reconstruction. The main purpose of the book is the presentation of the many variations of the Tram flap, inc!uding significant refinements. This section :of the book is logically presented with chapters covering anatomk, maintenance of cutaneous perfusion, general considerations and concepts of design before proceeding to the details of surgeryitself and an analysis of results. One mteresting idea in the structure of the book, which could well be adopted by others, is the use of an expert panel whose brief summa& is included at the end of each chapter. This is quite useful,
77 as it allows different points of view or emphasis to be commented on and these summaries contain valuable additional tips. I feel it is an exceilent book, which I would like to have had five or six years ago. There are eighteen pages by James Grotting on the free Tram flap and it is interesting to note how in a discussion on James Grotting’s paper in Plastic and Reconstructive Surgery, 53, 842, Hartrampf in the concluding paragraph states that, “if Dr Grotting and co workers continue to improve the method of free tissue Tram flap for breast reconstruction, making it a procedure that can be performed expeditiously with lower morbidity and higher reliability, and with the production of a quality breast, then those of use who are not micro surgeons will have to either acquire that skill or step aside”. I believe those conditions have now been met and that this book for most future plastic surgeons will represent a beautifully documented portion of the evolution of breast reconstruction, which justifiably carries Carl Hartrampf’s name. A. M. GODFREY Plastic Techniques in Neurosurgery. Eds. James T. Goodrich, Kalmon D. Post and Ravel0 V. Argamaso. (New York, Thieme Medical Publishers, Inc. ; Stuttgart, New York, Georg Thieme Vedag, 1991). Pp xviii+ 150. Iliustrated137 figs., 232 ills., 128 in colour. Price DM 188. It is perhaps au inevitable result of increasing surgical specialisation that it has become increasingly necessary (and desirable) for many complex procedures to be carried out not just by a surgeon from the discipline that appears most appropriate but by a multi-disciplinary team. This certainly applies to both neurosurgery and plastic surgery where, at one time, the only time that combined. procedures were likely to be performed was when surgery was required for the repair of extensive areas of skin loss over the skull. Wow, and in particular since the rise of crania-facial surgery, plastic surgeons and neurosurgeons frequently work together in order to bring their joint skills to bear on subjects that were once thought to be the province solely of each individual speciality. This book has been put together by a group of neurosurgeons and plastic surgeons, most of whom are working within the New York City area. It commences with three general sections that deal with the principles of wound healing, plastic surgery wound coverage for the neurosurgery patient and the repair of calvarial bone defects (including cranioplasty and bone-harvesting techniques). There are then sections on congenital malformations (this deals mainly with spinal and cranial dysraphism), crania-facial reconstruction for craniosynostosis, surgical techniques for the treatment of congenital facial disorders and, finally, surgery at the skull base. The presentation of the material is informal and based heavily on case reports. These are well illustrated, as are the many surgical techniques employed. I fmd it an attractive volume that will provide an excellent guide to this important “border area” for residents in both specialities. R. HAYWARD Male ALestheticSurgery: 2nd Edition. Ed. Eugene H. Courtiss. (St. Louis, Baltimore, Boston, Chicago, London, Philadelphia, Sydney, Toronto: Mosby-Year Book, Inc.) Pp. xxii + 435, Illustrated. ISBN 0801 658 381. Price $82.00 For the Plastic Surgeon with a general private practice, a book specifically on male aesthetic surgery may seem somewhat esoteric. A glance at the list of contents, however, will establish this book very fhmly in the mainstream of normal practice, dealing as it does withsuchcommonplaceconditionsastattoos,malepattem baldness, rhinoplasty, otoplasty, blepharoplasty, face lift and gynaecomastia. The book is a multi-author work edited by Eagene Courtiss and, as such, each chapter is complete in’its own right, so it is therefore easy to use as a reference source. It stands alone as a reference work on this subject. A glance at the chapters will prove rewarding for all but the most expert practitioner, with very many useful points of surgical technique explained. Many of these points are oniikely to be acquired in the formal teaching of post-graduate plastic surgery training, certiainly in Great Britain and possibly in the United States, for which the book has generally been aimed. The e*mphasis placed on patient selection and risk of medical liability is not misplaced in an era where this country seems set to follow the American trend of increasing Iitigation.
77 as it allows different points of view or emphasis to be commented on and these summaries contain valuable additional tips. I feel it is an exceilent book, which I would like to have had five or six years ago. There are eighteen pages by James Grotting on the free Tram flap and it is interesting to note how in a discussion on James Grotting’s paper in Plastic and Reconstructive Surgery, 53, 842, Hartrampf in the concluding paragraph states that, “if Dr Grotting and co workers continue to improve the method of free tissue Tram flap for breast reconstruction, making it a procedure that can be performed expeditiously with lower morbidity and higher reliability, and with the production of a quality breast, then those of use who are not micro surgeons will have to either acquire that skill or step aside”. I believe those conditions have now been met and that this book for most future plastic surgeons will represent a beautifully documented portion of the evolution of breast reconstruction, which justifiably carries Carl Hartrampf’s name. A. M. GODFREY Plastic Techniques in Neurosurgery. Eds. James T. Goodrich, Kalmon D. Post and Ravel0 V. Argamaso. (New York, Thieme Medical Publishers, Inc. ; Stuttgart, New York, Georg Thieme Vedag, 1991). Pp xviii+ 150. Iliustrated137 figs., 232 ills., 128 in colour. Price DM 188. It is perhaps au inevitable result of increasing surgical specialisation that it has become increasingly necessary (and desirable) for many complex procedures to be carried out not just by a surgeon from the discipline that appears most appropriate but by a multi-disciplinary team. This certainly applies to both neurosurgery and plastic surgery where, at one time, the only time that combined. procedures were likely to be performed was when surgery was required for the repair of extensive areas of skin loss over the skull. Wow, and in particular since the rise of crania-facial surgery, plastic surgeons and neurosurgeons frequently work together in order to bring their joint skills to bear on subjects that were once thought to be the province solely of each individual speciality. This book has been put together by a group of neurosurgeons and plastic surgeons, most of whom are working within the New York City area. It commences with three general sections that deal with the principles of wound healing, plastic surgery wound coverage for the neurosurgery patient and the repair of calvarial bone defects (including cranioplasty and bone-harvesting techniques). There are then sections on congenital malformations (this deals mainly with spinal and cranial dysraphism), crania-facial reconstruction for craniosynostosis, surgical techniques for the treatment of congenital facial disorders and, finally, surgery at the skull base. The presentation of the material is informal and based heavily on case reports. These are well illustrated, as are the many surgical techniques employed. I fmd it an attractive volume that will provide an excellent guide to this important “border area” for residents in both specialities. R. HAYWARD Male ALestheticSurgery: 2nd Edition. Ed. Eugene H. Courtiss. (St. Louis, Baltimore, Boston, Chicago, London, Philadelphia, Sydney, Toronto: Mosby-Year Book, Inc.) Pp. xxii + 435, Illustrated. ISBN 0801 658 381. Price $82.00 For the Plastic Surgeon with a general private practice, a book specifically on male aesthetic surgery may seem somewhat esoteric. A glance at the list of contents, however, will establish this book very fhmly in the mainstream of normal practice, dealing as it does withsuchcommonplaceconditionsastattoos,malepattem baldness, rhinoplasty, otoplasty, blepharoplasty, face lift and gynaecomastia. The book is a multi-author work edited by Eagene Courtiss and, as such, each chapter is complete in’its own right, so it is therefore easy to use as a reference source. It stands alone as a reference work on this subject. A glance at the chapters will prove rewarding for all but the most expert practitioner, with very many useful points of surgical technique explained. Many of these points are oniikely to be acquired in the formal teaching of post-graduate plastic surgery training, certiainly in Great Britain and possibly in the United States, for which the book has generally been aimed. The e*mphasis placed on patient selection and risk of medical liability is not misplaced in an era where this country seems set to follow the American trend of increasing Iitigation.