out this type of surgery are backed by large university departments, that there have been very few attempts to measure aesthetic outcome. The only group, to my knowledge, which has really addressed the issues is that from Bristol, using a computer programme to measure symmetry which would not have an application for an operation such as facelifting. There are, perhaps, pressures on surgeons to “remain fashionable” but this is by no means limited to private practice or to aesthetic surgery. This does not mean, however, that new techniques are not worthy of investigation and indeed one would hope that all surgeons would be keen to advance and improve the results in whatever field they find themselves. Mr Ward’s aims represent a council of perfection and cannot be criticised. Clearly
0 1996 The British
greater effort must be made to devise a measurement technique to quantify aesthetic outcome but presently it is difficult to see how this may be achieved. An issue of perhaps even greater importance at present is to improve training opportunities for young surgeons in aesthetic surgery (and to encourage them to take them up!) since virtually all plastic surgeons will carry out facial cosmetic surgery and very few will have formal training in it. Yours faithfully, Barry M. Jones MS, FRCS, Consultant Plastic and Craniofacial 14a Upper Wimpole Street, London WlM 7TB.
of Plastic Surgeons
Book Review Hair Transplantation, 3rd edition. Edited by Walter P. Unger. Marcel Dekker Inc., New York, March 1994. ISBN O-8247-9363-3. Pp xi + 830, ill. Price $195. Bobby Charlton tried to hide it. Yul Brynner made it his trademark. Copies of Hello magazine littering operating theatre coffee rooms are scanned to scrutinize the scalps of the treated. Baldness has been a feature of concern to the male (and sometimes female) since time began. To many patients it presents a source of great discomfort, and in the revised and expanded third edition of Hair Transplantation, Walter P. Unger has collected
panel of authors to review the current state of
assessment and treatment. A well presented volume with good black and white illustrations guides the reader through every method of hair replacement therapy. For those of us with little experience of the field the early chapters on classification, anatomy and instrumentation clearly illustrate this hitherto mysterious world. The book offers insight
into and explanation replacement
of the variety of hair transplantation
Most usefully for the general or head and neck plastic surgeon, this edition contains ten chapters on surgical scalp reconstruction. Tissue expansion and microvascular surgery are presented along with more established scalp flap techniques. The final chapter discusses new horizons and current developments. It is interesting that the last paragraphs dwell on hepatitis testing. Overall, this solid and neatly produced volume clearly leads the occasional or indeed devoted hair restorer through the maze of assessment, treatment and outcome. At $195 it is perhaps not a book for everyone but could be an unexpectedly valuable addition to any department library. It is said that men who are bald at the front are great thinkers and men who are bald at the back are great lovers whilst completely bald men think that they are great lovers.
Things have clearly moved on since Dieffenbach investigated the transplantation
in 1822! A. E. SEARLE
Unger’s own chapter on “The Patient Interview”
useful approach for all aspects of aesthetic surgery. The main chapters clearly discuss preparation of the patient, anaesthesia and techniques of hair graft. Good illustrations demonstrate results in appropriate cases and highlight methods of assessing outcome.
Notes on our Reviewer A. E. Searle FRCS, Consultant Surgery, Charing Cross Hospital, W6 8RF.
in Plastic and Fulham Palace
Reconstructive Road, London