Book Review

Reoperative Aesthetic and Reconstructive Plastic Surgery

N Engl J Med 1995; 333:949-950October 5, 1995

Article

Reoperative Aesthetic and Reconstructive Plastic Surgery
Edited by James C. Grotting. 1661 pp. in two volumes, illustrated. St. Louis, Quality Medical, 1995. $395. ISBN: 0-942219-25-2

Never before has an entire textbook been devoted to the subject of reoperative surgery. Usually the subject is covered in a few paragraphs at the end of a chapter. Yet, as pointed out in the foreword of Reoperative Aesthetic and Reconstructive Plastic Surgery, “all surgeons face reoperations as a routine part of their practices.” These reoperations are necessary to refine results, manage complications, or complete the final stage of a sequential procedure. The reoperative setting often tests even the most seasoned surgeon's skill and integrity. As stated in the preface, “The thread of commonality uniting all reoperative surgery is that the plastic surgeon finds himself confronting tissue planes biologically altered by the effects of wound healing.”

Editors of multiauthored textbooks face a real challenge to maintain uniformity of quality. The editor of this book states that he has attempted “to draw on the cumulative experience of master surgeons to increase our chances of obtaining a favorable result.” He has succeeded in doing just that. He has fashioned a mix of contributors consisting of senior professors, private practitioners, and plastic-surgery residents and fellows while maintaining a uniform approach and an excellent level of quality. The effort succeeds in part because of his supervision of manuscript preparation and in part because of his contributions as author or coauthor of nine chapters.

This book is much more than its title suggests. In order to foster a discussion of the philosophy, planning, and technique of reoperation, each author has reviewed the anatomy and blood and nerve supply of a specific body part and outlined the principles of the initial operation leading to the requirement for reoperation. This background and the clarity with which it is presented make this one of the most readable textbooks on plastic and reconstructive surgery. The illustrations are outstanding. Very clear drawings combined with color prints allow the reader to visualize what the text attempts to convey.

Having surgeons such as Horton discuss reconstruction of the genitalia; Stuzin, Baker, and Gordon discuss reoperative rhytidectomy; Burget discuss reoperative nasal reconstruction; Dellon discuss reoperative peripheral-nerve surgery; and Manders discuss problems with repeated tissue expansion certainly allows the reader to learn directly from the masters. Even lesser known authors have provided superior coverage of the subject. An example of this is Rubin's chapter “Imaging Considerations in Plastic Surgery of the Breast.”

Given such a massive undertaking, there is bound to be some unevenness. Not all chapters are as completely referenced as one might desire. For instance, the chapter on postoperative hematomas states that ketorolac thromethamine (Toradol) may cause hematoma, but no reference is given for the statement. Occasionally, a difficult problem is underemphasized — for example, the discussions of fat necrosis and virginal hypertrophy in chapter 27. These are perplexing problems for the reoperative surgeon, and little help will be found in this chapter.

This book offers good information for any plastic surgeon beyond that dealing with operative technique. The philosophical discussion in chapter 2, dealing with being “another surgeon” and with the angry patient, the dissatisfied patient, the patient with psychiatric problems, and the patient with pain, would be worth reading periodically throughout one's career. The final decision one must make regarding the plethora of new books published each year is which one to buy. I recommend Reoperative Aesthetic and Reconstructive Surgery; it may become a classic.

Martin Robson, M.D.
University of South Florida College of Medicine, Tampa, FL 33620