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A woman's decision: Breast care, treatment and reconstruction
Ermsh 0
Journai
of Plasric
1994 The Bntish
Surgery
Assocmtmn
(1994).
47. 585-586
of Plastic
Surgeons
Book Reviews Maxillofacial Injuries. A synopsis of basic principles, diagnosis and management. By G. Dimitroulis and B. S. Avery. Butterworth-Heinemann ISBN 0-7236-1010-X.
Ltd, Oxford, Price E19.95.
edition by patients have been noted and addressed. There is much of interest to be found here and a lot of up to date information on all aspects of the management of those suffering from breast cancer. Indeed, the specialist must beware and be fully informed when talking with an intelligent patient who has assimilated all the factual information that this book has to offer, and for this reason alone I would recommend this book to all those who are involved in the care and counselling of these patients. The chapter entitled *‘Breast Cancer Facts and Treatment Options ” is particularly well written and understandable; the authors call in acknowledged experts to help explain the facts, including new developments in breast cancer research. Those studying for specialist examinations would do well to read this chapter. The surgical options for breast reconstruction are presented in a logical and well illustrated fashion. The advantages and disadvantages of immediate versus delayed reconstruction are thoroughly discussed. The chapter entitled “Communicating With Your Doctors” is a humbling one; it reminded me of Goldwyn’s excellent book, The Plastic Surgeon and the Patient. For instance, the situation when a doctor tells the patient her prognosis or explains the proposed treatment when she is undressed is a familiar one in a busy outpatient clinic, but the caution that no woman can think clearly, when she is struggling to keep herself covered with a flimsy sheet or gown, should make one stop and think. The fact that the book is pitched at the insured American female is very obvious; the rather Utopian situation whereby the patient shops around for the surgeon who most suits her needs may not bear much comparison with normal British N.H.S. practice. and it would be interesting to known how non-insured patients treated in public or Veterans Administration hospitals fare. The final I3 1 pages are devoted to the personal accounts of 13 different women, which seemed to be overall very positive. This lends the book a rather folksy feel for the medical reader but it should be emphasised again that the book is really aimed at the general public. In fact, feedback from the previous edition suggested that this was one of the most valued sections of the book for those with newly diagnosed breast cancer. It also throws up some interesting differences in practice on both sides of the Atlantic, for example only one of the 13 women describing their experience with reconstruction had elected not to have nipple-areola reconstruction, one was undecided, the rest had decided “to go the whole way”. Apparently interviews and surveys with women who had had breast reconstruction revealed that when the reconstructed breast did not meet their aesthetic desires they did not want their nipple-areola restored because it would merely emphasise a poor result. Perhaps I should audit my own patients more carefully, because very few of them want an autologous nippleareola once they have had a silastic one made and coloured to match the other side; however, no mention was made of this technique in the book. Finally, the chapter on “What women want to know about breast implants” is a very up to date appraisal of the current situation regarding this much publicised topic. It is supported at the end of the book by detailed Appendices on Informed Consent in general and specifically relating to the use of gel-filled implants. At .f 15 this book is extremely good value and all those who are involved in guiding women to make their decisions following mastectomy should read it. J. H. PALMER
1994. Pp. vi + 115, ill.
This is a pocket-size textbook of 115pages written in the “notestyle” popularised by many undergraduate medical and dental textbooks. A textbook written in this style on maxillofacial injuries has been long overdue. The book is divided into 12 chapters. An introductory chapter covers basic principles of hard and soft tissue injury and the more general points regarding maxillofacial injuries, including clinical features, radiographic investigation, treatment options and some of the complications of treatment that may be encountered. The final chapter includes an important section on the assessment and management of head injuries which are so often associated with significant maxillofacial trauma. The remaining chapters cover injuries to each specific region of the maxillofacial complex with a separate chapter for discussion on the principles of rigid internal fixation as applied to maxillofacial fractures. Each chapter is laid out along similar lines describing applied anatomy relevant to the site followed by classification of injury, clinical features and treatment options. Where more than one line of possible treatment exists, advantages and disadvantages for each are given. The “notestyle” text is complemented by line drawings which are clear and easy to understand. At the end of each chapter there is a list of suggested further reading, drawing both on textbooks and publications within relevant journals. At the end of the book there is a comprehensive index which makes location of a specific topic easy. This paperback textbook is small and will easily fit into the pocket of a white coat. Undoubtedly the succinct style and the comprehensive coverage of the topic will make it an attractive buy for maxillofacial surgery house officers and senior house officers. It should also prove attractive to both final year dental undergraduates and also those sitting the fellowship in dental surgery. It will also prove a valuable and handy reference manual for both accident and emergency senior house officers and those members ofjunior staff in specialities such as plastic surgery who may well be involved in the management of patients who have sustained maxillofacial injuries. If I have two criticisms they would be that insufficient space is devoted to the general principles and management of multiply injured patients particularly with reference to the ATLS protocol, and 1 think that a chapter devoted to cervical spine injuries, their assessment and immediate management would have been valuable. if only to stress the potential for this form of injury in any patient with a maxillofacial fracture. Whilst undoubtedly this is an excellent textbook which should find broad appeal, the recommended price of f19.95 1 think may prove a disincentive to some of those who would find this book most valuable. N. M. WHEAR
A Woman’s Decision: Breast Care, Treatment and Reconstruction, 2nd edition. By Karen Berger and John Bostwick III. Quality Medical Publishing Inc., St. Louis, Missouri, 1994. Pp xviii +564, ill. ISBN 0-942219-04-X. Price $18. This is the second edition of an interesting American book written by a leading medical publisher/writer together with a renowned surgeon. The stated purpose of the book is to offer a comprehensive and easily understandable account of reconstructive breast surgery to the general public to inform them of the physical and psychological transformation that can be achieved by appropriate surgery. With 564 pages, it is certainly comprehensive and, as one would expect in a second edition, most of the criticisms levelled at the first 585
Journai
of Plasric
1994 The Bntish
Surgery
Assocmtmn
(1994).
47. 585-586
of Plastic
Surgeons
Book Reviews Maxillofacial Injuries. A synopsis of basic principles, diagnosis and management. By G. Dimitroulis and B. S. Avery. Butterworth-Heinemann ISBN 0-7236-1010-X.
Ltd, Oxford, Price E19.95.
edition by patients have been noted and addressed. There is much of interest to be found here and a lot of up to date information on all aspects of the management of those suffering from breast cancer. Indeed, the specialist must beware and be fully informed when talking with an intelligent patient who has assimilated all the factual information that this book has to offer, and for this reason alone I would recommend this book to all those who are involved in the care and counselling of these patients. The chapter entitled *‘Breast Cancer Facts and Treatment Options ” is particularly well written and understandable; the authors call in acknowledged experts to help explain the facts, including new developments in breast cancer research. Those studying for specialist examinations would do well to read this chapter. The surgical options for breast reconstruction are presented in a logical and well illustrated fashion. The advantages and disadvantages of immediate versus delayed reconstruction are thoroughly discussed. The chapter entitled “Communicating With Your Doctors” is a humbling one; it reminded me of Goldwyn’s excellent book, The Plastic Surgeon and the Patient. For instance, the situation when a doctor tells the patient her prognosis or explains the proposed treatment when she is undressed is a familiar one in a busy outpatient clinic, but the caution that no woman can think clearly, when she is struggling to keep herself covered with a flimsy sheet or gown, should make one stop and think. The fact that the book is pitched at the insured American female is very obvious; the rather Utopian situation whereby the patient shops around for the surgeon who most suits her needs may not bear much comparison with normal British N.H.S. practice. and it would be interesting to known how non-insured patients treated in public or Veterans Administration hospitals fare. The final I3 1 pages are devoted to the personal accounts of 13 different women, which seemed to be overall very positive. This lends the book a rather folksy feel for the medical reader but it should be emphasised again that the book is really aimed at the general public. In fact, feedback from the previous edition suggested that this was one of the most valued sections of the book for those with newly diagnosed breast cancer. It also throws up some interesting differences in practice on both sides of the Atlantic, for example only one of the 13 women describing their experience with reconstruction had elected not to have nipple-areola reconstruction, one was undecided, the rest had decided “to go the whole way”. Apparently interviews and surveys with women who had had breast reconstruction revealed that when the reconstructed breast did not meet their aesthetic desires they did not want their nipple-areola restored because it would merely emphasise a poor result. Perhaps I should audit my own patients more carefully, because very few of them want an autologous nippleareola once they have had a silastic one made and coloured to match the other side; however, no mention was made of this technique in the book. Finally, the chapter on “What women want to know about breast implants” is a very up to date appraisal of the current situation regarding this much publicised topic. It is supported at the end of the book by detailed Appendices on Informed Consent in general and specifically relating to the use of gel-filled implants. At .f 15 this book is extremely good value and all those who are involved in guiding women to make their decisions following mastectomy should read it. J. H. PALMER
1994. Pp. vi + 115, ill.
This is a pocket-size textbook of 115pages written in the “notestyle” popularised by many undergraduate medical and dental textbooks. A textbook written in this style on maxillofacial injuries has been long overdue. The book is divided into 12 chapters. An introductory chapter covers basic principles of hard and soft tissue injury and the more general points regarding maxillofacial injuries, including clinical features, radiographic investigation, treatment options and some of the complications of treatment that may be encountered. The final chapter includes an important section on the assessment and management of head injuries which are so often associated with significant maxillofacial trauma. The remaining chapters cover injuries to each specific region of the maxillofacial complex with a separate chapter for discussion on the principles of rigid internal fixation as applied to maxillofacial fractures. Each chapter is laid out along similar lines describing applied anatomy relevant to the site followed by classification of injury, clinical features and treatment options. Where more than one line of possible treatment exists, advantages and disadvantages for each are given. The “notestyle” text is complemented by line drawings which are clear and easy to understand. At the end of each chapter there is a list of suggested further reading, drawing both on textbooks and publications within relevant journals. At the end of the book there is a comprehensive index which makes location of a specific topic easy. This paperback textbook is small and will easily fit into the pocket of a white coat. Undoubtedly the succinct style and the comprehensive coverage of the topic will make it an attractive buy for maxillofacial surgery house officers and senior house officers. It should also prove attractive to both final year dental undergraduates and also those sitting the fellowship in dental surgery. It will also prove a valuable and handy reference manual for both accident and emergency senior house officers and those members ofjunior staff in specialities such as plastic surgery who may well be involved in the management of patients who have sustained maxillofacial injuries. If I have two criticisms they would be that insufficient space is devoted to the general principles and management of multiply injured patients particularly with reference to the ATLS protocol, and 1 think that a chapter devoted to cervical spine injuries, their assessment and immediate management would have been valuable. if only to stress the potential for this form of injury in any patient with a maxillofacial fracture. Whilst undoubtedly this is an excellent textbook which should find broad appeal, the recommended price of f19.95 1 think may prove a disincentive to some of those who would find this book most valuable. N. M. WHEAR
A Woman’s Decision: Breast Care, Treatment and Reconstruction, 2nd edition. By Karen Berger and John Bostwick III. Quality Medical Publishing Inc., St. Louis, Missouri, 1994. Pp xviii +564, ill. ISBN 0-942219-04-X. Price $18. This is the second edition of an interesting American book written by a leading medical publisher/writer together with a renowned surgeon. The stated purpose of the book is to offer a comprehensive and easily understandable account of reconstructive breast surgery to the general public to inform them of the physical and psychological transformation that can be achieved by appropriate surgery. With 564 pages, it is certainly comprehensive and, as one would expect in a second edition, most of the criticisms levelled at the first 585