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Cosmetic Oculoplastic Surgery—Eyelid, Forehead, and Facial Techniques

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    Cosmetic Oculoplastic Surgery—Eyelid, Forehead, and Facial Techniques. 3rd ed. By Allen M Putterman. Pp 500; £96. London: WB Saunders, 1999. ISBN 0-7216-7076-8.

    This book is designed principally as a reference for surgeons engaged in cosmetic blepharoplasty work, but also covers forehead, eyebrow and facelifts, and adjunctive treatments such as chemical and laser skin resurfacing. Despite this, there is an enormous amount of information within this volume that is extremely useful for those engaged in oculoplastic work outside the aesthetic field. There is no reason at all why surgery for functional abnormalities should not be planned with regard to the eventual cosmetic result and the two aims are often coincidental. Most surgeons will be able to find a lot of helpful advice that can be used in improving the results of surgery for ectropion or for lid retraction or involutional ptosis.

    This book has contributions from a number of different authors, but is prolifically illustrated throughout by the same artist, with great clarity, lending a cohesion to the volume which is reinforced by introductions to each chapter from the principal author.

    Each chapter tends to explore one particular surgical technique, with clear step by step instructions. Many stages, such as excision of orbital fat prolapse, are common to a number of different procedures and are described in similar detail in several chapters; this leads to much repetition if one is reading the book from end to end, but is very helpful in reducing the number of cross references if it is being used as a surgical manual.

    Although the main part of the book is devoted to surgical techniques, there are a number of extremely useful chapters on more general topics such as the assessment of the oculoplastic patient, patient selection, and the factors involved in determining patient satisfaction with the outcome of treatment. People presenting for cosmetic surgery often have high expectations of what surgery has to offer and a low tolerance of suboptimal results, but they are not necessarily very different from patients seeking other forms of elective surgery and much of the advice on preoperative assessment, counselling, and communication is widely applicable to much of ophthalmology.

    This is a very usable surgical textbook that offers ample information and advice to enable most oculoplastic surgeons to feel confident to extend and modify their repertoire to give their patients the optimum results functionally and aesthetically. It manages to achieve this while challenging us to look hard at the way we practise and the way we relate to our patients.