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Textbook of Plastic and Reconstructive Surgery

Textbook of Plastic and Reconstructive Surgery OPEN ACCESS

Deepak M. Kalaskar
Peter E. Butler
Shadi Ghali
Copyright Date: 2016
Edition: 1
Published by: UCL Press
Pages: 472
Stable URL:
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  • Book Info
    Textbook of Plastic and Reconstructive Surgery
    Book Description:

    Written by experts from London’s renowned Royal Free hospital, Textbook of Plastic and Reconstructive Surgery offers a comprehensive overview of the vast topic of reconstructive plastic surgery and its various subspecialties for introductory plastic surgery and surgical science courses. The book comprises five sections covering the fundamental principles of plastic surgery, cancer, burns and trauma, paediatric plastic surgery and aesthetic surgery, and covers the breadth of knowledge that students need to further their career in this exciting field. Additional coverage of areas in which reconstructive surgery techniques are called upon includes abdominal wall reconstruction, ear reconstruction and genital reconstruction. A section on aesthetic surgery includes facial aesthetic surgery and blepharoplasty, aesthetic breast surgery, body contouring and the evolution of hair transplantation. The broad scope of this volume and attention to often neglected specialisms such as military plastic surgery make this a unique contribution to the field. Heavily illustrated throughout, Textbook of Plastic and Reconstructive Surgery is essential reading for anyone interested in furthering their knowledge of this exciting field.

    eISBN: 978-1-910634-37-0
    Subjects: Health Sciences
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Table of Contents

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    • George Adigbli, Feras Alshomer, Jekaterina Maksimcuka and Shadi Ghali

      Plastic and reconstructive surgery is a branch of surgery that specialises in restoring form and function to damaged or missing tissues and skin. The causes of such defects are usually related to surgery, injury, illness or congenital abnormality. This rapidly evolving specialty is based upon the exploitation of key principles of anatomy, physiology, pathology and surgery. Mastery of these principles as well as the acquisition of sound surgical technique enables plastic surgeons to constantly adapt to the wide variety of individual cases they face and provide functional and aesthetic solutions.

      Comprehensively describing and explaining all of the principles of plastic...

    • Ali Alhamdi and Shadi Ghali

      There are various types of abdominal wall defects, with various and sometimes overlapping management options. Interventions can vary from simple coverage and contouring to reconstruction with dynamic functional abdominal wall muscles (Garridoet al., 2013 ) depending on factors relating to the defect, such as the type of tissue loss (skin, muscles or fascia), as well as factors relating to the size of the defect and degree of wound contamination. Other considerations including patient factors are also important, such as emergency versus elective presentation, patient co-morbidities and previous surgery. Furthermore, treatment of the abdominal defects is based on the following...

    • Sophia Opel and Shadi Ghali

      Skin cancer is one of the most common types of cancer in the world and forms part of the daily experience of plastic surgeons. Therefore, it is imperative that clinicians are able to recognise clinical features suggestive of malignancy. Skin malignancies can be broadly grouped into non-melanocytic types of skin cancer (i. e. squamous cell carcinoma and basal cell carcinoma) and melanoma. Basal cell carcinoma (BCC) is the most frequently occurring form of all cancers in Europe, Australia and the USA, and its incidence is increasing (Harriset al., 1990; Koet al., 1994). It is not uncommonly known as...

    • Jatinder T. Virdee and Nicholas Kalavrezos

      Oral cancer is the sixth most common cancer in the world, and is ranked as one of the top three cancers in areas of high incidence (Warnakulasuriya, 2010) . It represents a significant component of the global cancer burden (Peterson, 2009) and is a major problem in regions in which tobacco chewing and smoking are common (Ziniet al., 2010). It is mostly preventable through lifestyle changes (Warnakulasuriya, 2010). In 2004, the International Head and Neck Cancer Epidemiology consortium was set up to obtain a better understanding of head and neck squamous cell carcinomas (HNSCCs) by studying large-scale pooled data...

    • 5 Burns (pp. 103-121)
      Sebastian Salinas, Salman Mofti and Naime Moimen

      The skin is the most extensive organ of the human body: it keeps it separate from the external environment, regulates its temperature and protects it from infection. However, this barrier can be destroyed in 1 second when burned.

      Burns still constitute one of the main accidents in homes and industry, and are also linked to social and economic risk factors. A good education and awareness of this problem is the first pillar in decreasing the morbidity and mortality rates caused by burns. The second fundamental pillar is prompting assistance and adequate treatment to improve outcomes and avoid complications.

      Despite the...

    • Barinder Takhar, Ahmad B. Al-Ali and Naime Moimen

      Burns can be horrific injuries and can vary greatly in severity, often resulting in significant physical and psychological impact on the patient’s health and well-being. The resulting injuries can cause functional and aesthetic problems, as well as significant morbidity and mortality. This chapter describes the process of reconstructive surgery after burns, the reconstruction options available and the principles of reconstructive surgery including the reconstructive ladder.

      Advances in reconstructive surgery due to new materials and techniques for the management of burns have benefited burn survivors via improving the physical appearance and function, thus improving their quality of life. However, a balance...

    • Hiba Khan and Bran Sivakumar

      The human hand has evolved into one of the most complex structures in nature. This complexity affords the hand remarkable dexterity, fine motor control and tactile feedback. We are dependent on our hands for most activities of daily living: loss of hand function can have devastating consequences on quality of life, affecting a person’s ability to work, communicate and live independently.

      While the functional aspects of hand reconstruction remain the surgeon’s main concern, it is important to appreciate the impact of the aesthetic result on a patient’s quality of life. After the face, the hand is the most exposed body...

    • Rebecca Nicholas, Ayyaz Quddus and Jon Simmons

      High-energy lower limb trauma can result in complex bone and soft tissue injury, with associated vascular and nerve damage. Advances since the mid-1990s in fracture fixation and soft tissue management, including microsurgical reconstruction, have altered the trend in favour of limb salvage as opposed to limb amputation (Ong & Levin, 2010) . The joint British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and British Orthopaedic Association (BOA) Standards for the Management of Open Fractures of the Lower Limb, published in 2009, highlight the vital importance of a multidisciplinary approach between orthopaedic and plastic surgeons with appropriate clinical experience from...

    • Tom W. Andrew and Nicholas Kalaverozos

      Facial trauma management is evolving, primarily owing to developments in imaging and bone fixation technology and the application of microsurgical techniques, including the recent potential for allograft reconstruction (Devauchelleet al., 2006 ). An appreciation of the psychological complications of facial fractures, the shift toward early one-stage repair with immediate bone grafting and the use of cosmetic incisions highlights the change. Management is most effective within a multidisciplinary team; however, plastic surgeons are uniquely placed in this unit because they are trained to handle the full spectrum of pathology from urgent stabilisation to late surgical revision, without the discrimination of...

    • Benjamin Way and Bran Sivakumar

      Development of the upper limb begins at around day 24 of gestation, when arm buds of the somatopleuric lateral plate mesoderm, capped by their overlying ectoderm, begin proliferating bilaterally in the lower cervical regions. Over the following 4 weeks, these buds enlarge and differentiate, and with the added migration of other cell types into the buds from deeper embryonic structures, form all the tissues of the limb.

      As the limb bud elongates, it must differentiate in three axes to provide the complex structures of the limb: proximodistal, craniocaudal and dorsoventral. The first manifestation of this patterning is the appearance of...

    • Aurora Almadori, Abdulaziz Khurshed, Ali Jafar, Ahmad B. Al-Ali and Peter E. Butler

      The external ear is composed of the auricle and the external acoustic meatus. It has a functional and aesthetic role: it participates in the transmission of the sound waves and represents a unique element of personality and aesthetic harmony owing to its peculiar symmetrical and specular shape and position on the head.

      Several conditions can affect the auricle leading to a total or partial defect, which can be extremely disabling for the patient who may complain of diminished self-confidence, emotional distress and dif-ficulties in social interaction (Ballantyne, 1976; Horlocket al., 2005). The aim of reconstruction is to restore the...

    • Ahmed Al-Hadad and Shafiq Rahman

      Craniofacial surgery is a growing subspecialty that seeks to manage congenital and acquired malformations of the face, skull and jaw. Craniofacial surgeons deal with a vast range of conditions including craniosynostosis and craniofacial clefts, as well as various miscellaneous congenital malformations. This chapter aims to cover the basic anatomy and embryology of the skull and palate, and then focuses on the common craniosynostosis syndromes, cleft lip and palate (CL/P).

      Craniosynostosis dates back to 100 BC, when it was initially described by Hippocrates. It is defined as the premature fusion of one or more cranial sutures either during developmentin utero...

    • Shomari Zack-Williams, Debbie Hunt, Asif Muneer and Sarah Creighton

      Disorders of sexual development (DSDs) are the most common reasons for genital reconstruction in children

      A discussion of the genetics, molecular pathways and surgical management of DSDs is provided Disorders related to DSDs, e. g. cryptorchidism and hypospadias, are discussed The art and practice of genital reconstruction is an area of much complexity and a challenge to the reconstructive surgeon. Successful genitourinary (GU) reconstruction involves the collaboration of medical, surgical and allied health professional teams working in a multidisciplinary setting to ensure that the best treatments are performed on these patients. The field of GU reconstruction ranges from congenital disorders...

    • Wenceslao M. Calonge, Juan Carlos López-Gutiérrez and Neil Bulstrode

      Vascular anomalies (tumours and malformations) are the commonest congenital anomalies in humans. They constitute a broad spectrum of conditions ranging from lesions that resolve leaving no clinical signs to life-threatening lesions.

      Their classification and nomenclature have now been unified. Historically, a plethora of histopathological terms and culinary comparisons in all hues of red has been used. In spite of continual efforts, many recent textbooks in paediatrics, surgery, dermatology and radiology persist in using this ancient terminology. In what remains the most cited article in the history of plastic surgery (Mulliken and Glowacki, 1982), Mulliken and Glowacki in 1982 proposed a...

    • 15 Liposuction (pp. 333-345)
      Nina Oliver, Omar Khan Pathan and Ash Mosahebi

      Liposuction is also known as lipectomy, lipoaspiration, liposculpture and lipoplasty. In Britain, there was a 41% increase in liposuction cases in 2013 (The British Association of Aesthetic Plastic Surgeons, 2014 ). In 2013, the American Association of Aesthetic Plastic Surgery reported liposuction as the most popular surgical procedure, with an increase of 16% from the previous year. Initially, liposuction was most popular in women, but over the years liposuction has become increasingly popular in the male population and now tops the list of aesthetic surgical procedures for both sexes (ASAPS, 2014 ).

      Liposuction is a surgical procedure that involves the...

    • Muholan Kanapathy and Niall Kirkpatrick

      Facial aesthetic procedures have been rapidly growing in number across the globe over the past few decades. Globalisation and social media have played a major role in encouraging patients to undergo these procedures (The American Society for Aesthetic Plastic Surgery, 2010 ). Surgeons therefore have a greater responsibility to appropriately educate patients and use careful patient selection criteria to choose the appropriate candidates for the treatment.

      Considerations regarding patient selection and pre-operative counselling for aesthetic surgery include a clear understanding of the patient’s perception of their problem and their expectations of surgery as well as knowledge of a wide range...

    • Billy Ching Leung, Kimberley Lau and Hugo Henderson

      Asian blepharoplasty, i.e. the surgical creation of an upper eyelid crease, is one of the most popular types of aesthetic surgery performed on those of Asian descent (Chinese, Japanese, Korean); it was first described by Mikamo in 1896. A prominent upper lid crease is deemed by some to be more ‘attractive’ in Asian culture because it gives a more ‘wide eyed’ and expressive appearance. This chapter aims to summarise, and highlight through illustrations, the essential anatomy and surgical techniques of Asian blepharoplasty to enhance the understanding of the procedure of medical students and junior trainees.Anatomy: The lack, or absence,...

    • Log Murugesan, Julia Ruston and Patrick Mallucci

      This chapter on aesthetic breast surgery provides key facts that are useful as a quick reference. To facilitate this, information is presented in bullet point format, but it should by no means be considered exhaustive. The reference section and the appendix should guide the reader to more in-depth information and are highly recommended. Important developmental and anatomical facts are introduced first, followed by information that provides a foundation to the constantly evolving fields of breast augmentation, mastopexy and breast reduction. An understanding of the basic embryological, development and anatomical concepts will give the reader a better understanding of the key...

    • 19 Body Contouring (pp. 409-430)
      Zain Bukamal and Ash Mosahebi

      Today self-image is largely influenced by self-perception; a small waist diameter has become a matter of concern to both women and men such that many people with various concerns including aesthetic and functional bodily issues are increasingly seeking surgical intervention (Achaueret al., 2000 ). As a consequence, new techniques have been implemented in the aesthetic field of plastic surgery and have increasingly improved the long-term post-operative results, providing greater patient satisfaction.

      Body contouring is defined as a procedure(s) that involves the removal of excess subcutaneous fat and skin; it mainly consists of liposuction with or without an open surgical...

    • Farhana Akter and Greg Williams

      Human hair performs a number of functions in the body including insulation, regulation of body temperature and protection from external factors. It also has an important aesthetic function; consequently, hair loss can cause immense psychological stress. Patients suffering from hair loss are more likely to suffer anxiety, social phobia and depression compared with the general population (Kooet al., 1994 ), and the effect of unwanted hair loss is said to be comparable to bereavement (Egele and Tauschke, 1987). It is therefore understandable that hair restoration therapy is a major field in scientific research and aesthetic surgery.

      In this chapter,...