BOOK REVIEWS

HAIR TRANSPLANT SURGERY. By O’TAR T. NORWOOD, M.D. Pp. 108 with 6g illustrations. (Springfield, Illinois: Charles C. Thomas.) Price $10.50.

In the preface the author describes how, some years ago, he gave up hair transplantation because of the disappointing results. However, faced himself with progressive baldness, he had 300 plug grafts inserted in his own scalp with a beautiful result and once again took up hair transplantation. This cautionary tale emphasises that, no matter how easy it may look, hair transplantation is not a procedure for the occasional surgeon; for best results it requires careful selection of cases and punctilious attention to detail. This book is entirely about punch grafts and all aspects are fully described, but a discussion about strip grafting and transposition flaps would have made it more complete. There are more than 60 colour illustrations, but the standard of photography and/or publication is poor and the results shown are not very convincing. However, there seems to be a continuing demand for this operation, which must indicate that the results are usually worth while.

T. GIBSON

SYMPOSIUM ON NEOPLASTIC AND RECONSTRUCTIVE PROBLEMS OF THE FEMALE BREAST. Edited by REUVEN K. SNYDERMAN. Pp. 120 with II illustrations. (Distributed by Henry Kimpton, 205 Great Portland St., London WIN 6LR. St Louis, 1973.) Price jJ7.90.

Published by C. V. Mosby Co.,

The proceedings of a symposium sponsored jointly by the Educational Foundation of the American Society of Plastic and Reconstructive Surgeons and the Memorial Sloan-Kettering Cancer Centre, New York, in February 1972, have been edited by Dr Reuven Snyderman, who has incorporated some additional in- formation from a symposium held by the American Society of Plastic and Reconstructive Surgeons in September 1972 into an attractive hard-back volume of almost IOO pages of text, 15 pages of bibliography derived from the extensive writings of the contributors, and a brief index. The contributors are general and plastic surgeons supported by pathologists, radiologists and pure research workers.

Early chapters deal with the magnitude of the problems of breast cancer and the pathological and clinical aspects of premalignant disease of the breast, quoting considerably from the literature (mostly American) to demonstrate the scientific basis for the treatment of women either because they are in high- risk categories or because of certain biopsy findings. A chapter on radiology of the breast specimen, to confirm that suspicious areas noted on the mammogram were indeed being sectioned, seemed particularly useful. These chpters provide welcome information for plastic surgeons in this country whose general surgical colleagues may well be responding to the changing opinions of the treatment of pre- and established malignancy by offering cases for reconstruction.

The middle section of the book deals with breast augmentation after subcutaneous mastectomy and with reduction mammaplasty; to the plastic surgeon most will be already known.

Later chapters of the book cover the additional problems of augmentation following radical mastectomy and irradiation. The need to explain the shortcomings of present techniques is emphasised while a firm conviction emerges that for many women the distress of mutilation is alleviated by less than perfect aesthetic results.

As Dr Bromley Freeman writes, it will be more than a decade before we can know if subcutaneous mastectomy prevents frank cancer of the breast and whether the use of implants in the post-radical mastectomy patient prejudices the diagnosis of recurrence or increased mortality. There can, however, be little doubt of the psychological support which reconstruction gives to many women.

R. W. PIGOTT

RADIODERMITES DES MAINS. By F. LAGROT. Doin Editeurs, 1974.) Price: 120.00 F.

Pp. x+ 231 with 146 illustrations. (Paris:

This attractively designed monograph is the final distillation of the author’s unrivalled experience in the surgical treatment of radiodermatitis of the hands. It represents 25 years of careful clinical observation (from 1948 onwards) and describes how this very distinguished French surgeon, working first in Algiers and later in Toulouse, developed his surgical approach to the treatment of this condition and modified his technique in the light of experience. Due credit is given to the pioneer work of the American Charles Allen Porter, at the turn of the century, and there are several references to the writings of the early British and American plastic surgeons on the surgical problems by the undesirable effects of radiotherapy.

What is so remarkable about this study is that the 109 hands that were treated surgically all belonged to professional people, most of them doctors, and the exposure to radiation occurred at a time when the pos- sible hazards of radiation were certainly recognised if not fully understood. Yet time and again the early warning signs of changes in the skin, especially in the region of the nail bed and finger tips, were ignored

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