neligan plastic surgery pdf free download

The arrival of the latest edition of the most hallowed plastic surgery textbook series is an auspicious occasion. The day I matched in plastic surgery, I bought "McCarthy." How I loved that regal green binding and the heavily serifed fonts, which harkened back to the old world of Viennese medical education! Doing credit to the legendary dynasty of Drs Converse and McCarthy is a Herculean task, and Plastic Surgery series editor Dr Peter C. Neligan and volume 5, Breast, editor Dr James Grotting do not disappoint. This impressive volume (the third edition) is much larger than the original edition; the book explodes with colorful illustrations and beautiful photos, and each page is marked with indices at the top.

Although I was obviously excited by my initial McCarthy purchase, the books ended up being of little use, as they contained too much history and not enough practical information about the field. For instance, the cleft lip chapter was extensive but did not provide information necessary to be prepared in the operating room. The chapter featured 1 old drawing of a cleft lip repair, one following adhesion. I was astounded that this ostensibly authoritative book did not clearly show the steps of the operation. With this new edition, I was excited to realize how far we have come in our specialty and how much the editors have improved this volume.

Strengths

Each textbook of the newly edited Plastic Surgery series is $285; the price for the entire 6-volume set is $1550. The Breast volume can also be purchased as a Kindle edition for $156, and the electronic version of the set is $854. The Kindle edition is identical to the print edition but obviously much lighter; it provides the same access to the online edition and videos. There cannot be a better value in all of the world than acquiring the Kindle edition for the price of about one Starbucks latte a day during a single rotation. An unexpected treat is that all photos of the book can be exported as PowerPoint files, allowing purchasers to use the illustrations in presentations.

In the current Breast volume, some procedures are introduced in similar lack of detail as the original McCarthy edition, but other procedures receive extensive focus. The text and video for Dr Neil Fine's endoscopic breast augmentation chapter are outstanding. Not only will it expertly prepare a resident for this procedure in the operating room, but it can also teach any advanced surgeon how to perform a better endoscopic breast augmentation.

The plan behind this text/online format seems to suggest that this—and the other volumes in the set—can become a "living textbook," with videos and texts added over time. Although there are no current plans for how this might be accomplished, it certainly seems technically possible and suggests how a future edition might look.

Weaknesses

For me, nothing beats the smell of a paper-and-ink textbook. Yet I am addicted to my Kindle and iPad. Accordingly, the book's inside cover features a unique code for use on the publisher's website, where you will find the entire text, a supplemental bibliography with links to the abstracts, and a plethora of videos. However, after perusing the online information, I was disappointed with its functionality: Navigating the text was a bit cumbersome, and while the fonts look great on Kindle, reading the electronic version for hours would become tiresome (although it does allow for printing a chapter at a time, to roll up in your lab coat, which is an advantage).

Plastic surgeons have become accustomed to high-quality videos and easy online navigation. The legendary Bruce Solomon team that shoots the Baker-Gordon-Stuzin meetings raised the quality of video education to phenomenal levels, possibly allowing for better education than visiting expert surgeons in their own operating rooms. Professional cameras, special lighting of body cavities, inserting endoscopic footage, tight editing, and a total graphical package are expected today. Device manufacturers in particular can be credited for producing outstanding educational videos.

The videos appended to this textbook are quantitatively and qualitatively inconsistent, featuring some basic procedures—but not all. Conspicuously absent are videos on the most common aesthetic surgery procedures, such as a periareolar augmentation, inframammary augmentation, inferior pedicle reduction/lift, and a superomedial pedicle vertical lift/reduction. Some videos are professionally produced, while others seem to have been shot on shakily held smartphones. I cannot fault the editors. As an occasional author of book chapters, I have had editors hound me to submit a video; without a budget to shoot a commercial-quality video for each chapter, expecting high-quality videos is unreasonable. However, there is no excuse for the dysfunctional video user interface. I was unable to fast-forward videos on either a Mac or a Windows platform, which made the process frustrating to use.

Each type of breast reduction has its own chapter. But other than the endoscopic augmentation chapter, breast augmentation in general—which includes transaxillary, periareolar, and inframammary approaches—is covered by a single chapter. Furthermore, as the most commonly performed aesthetic operation, the breast augmentation chapter unfortunately would not prepare a resident to fully plan, let alone perform, an augmentation. In contrast is the entire chapter devoted to the highly specific SPAIR technique (short-scar periareolar inferior pedicle reduction), which has just a handful of devotees. The SPAIR chapter is excellently written and illustrated but is probably less relevant to most readers than would be, for instance, a chapter outlining each step of an inframammary augmentation.

In the foreword, the editors mention that they have shortened the bibliographies and redundancies to make the book less repetitive and readable. That may have been done somewhat, but the breast augmentation chapter inexplicably features a 3-page chart on herbs to avoid, a feature unnecessary in this volume. Are perioperative recommendations for devil's claw and tortoise jelly that important? Are 6 full pages of preoperative and augmentation photos necessary? Would not illustrations of the operation's sequence be more valuable?

Summary

To be fair, this is a 604-page volume that includes both aesthetic and reconstructive breast surgery; it cannot be expected to encompass the same scope or depth as a 2-volume set on aesthetic surgery alone. Nor can it have the depth of a purchasable 4-hour society course on a single procedure. But anyone who reads this entire volume will learn a great deal about breast surgery, as written by unequivocal world authorities.

What is the role of such a book today? We have numerous information sources: The combination of online journals (that sometimes incorporate videos), online educational portals for implant manufacturers, and the massive amount of educational material immediately available on RADAR (the iPad app of Aesthetic Surgery Journal and the American Society for Aesthetic Plastic Surgery) and via other resources clearly exceeds that which can be included in any textbook. But slogging through such material piecemeal fails to provide a cogent educational base. There is no substitute for having a giant of breast surgery such as Dr Grotting compile, organize, and make sense of the available information.

This volume belongs in every resident's library. The only real decision is deciding on either the Kindle or print edition. While I did not see how the illustrations look on the Kindle, its price makes it a compelling purchase.

Dr Converse: Your baby has grown into a fine adult.