The Nose – Revision and Reconstruction

Review by Miss C Hopkins
Guy’s & St. Thomas’ Hospitals, London

There has been a run of rhinoplasty books published in recent months; some good, some bad and one or two frankly ugly, but fortunately this one falls into the first group (however, some of the results depicted prior to revision definitely in the latter!). Although primarily focused on revision surgery, it will be of value for anyone undertaking rhinoplasty in their surgical practice.

It is often said that one should never undertake an operation unless you can deal with any complication that arises. It seems that, in rhinoplasty, this adage is too easily ignored, as the ‘complication’ is often apparent only at follow-up, with the unhappy patient referred on elsewhere for revision. This book will help to address this – by both improving one’s understanding of why an unfavourable result may occur and thus preventing the error from being repeated, but also providing very clear examples of how to correct the results at revision surgery.

The chapters on tissue replacement in the nose, sutures and structural grafting and management of over-resection of the dorsum are particularly useful. There are high quality case illustrations throughout, and, with the majority of the chapters being written by Behrbohm , a consistency in approach and style. The psychological and motivation issues to each case, paramount in the success or failure of surgery, are clearly discussed.

Some of the results of primary rhinoplasty which are depicted are frankly scary, so it seems appropriate that I write this with Halloween approaching. It’s a valuable lesson as to how badly things can go wrong, so, if nothing else, it’s a good warning to anyone thinking they can make some easy money. Having ensured that none of the revision cases were mine, I enjoyed the wide range of cases discussed – I’m very happy to learn from someone else’s experiences of when things go wrong, rather than wait for my own to accumulate. This probably isn’t the first rhinoplasty textbook to buy, as one starts out (I’d still recommend Sclafarni’s Rhinoplasty: The Experts’ Reference for that), but this is a close second – and there would be great value in having both on the bookshelf. At a £100, it’s a worthwhile investment.

Amazon Link: The Nose – Revision and Reconstruction
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