Cosmetic Dermatology: Principles and Practice. By Leslie Baumann, M.D. Pp. 226. McGraw-Hill, New York, N.Y., 2002. Price $149.
The most common evolution of a plastic surgeon’s practice begins with endless days and nights in the emergency room, repair of numerous complex lacerations, re-approximation of the dreaded, elusive “vermilion border,” and management of chronic, nonhealing wounds. As we begin to earn our reputation for hard work and technical prowess, we all hope that the world will notice this “diamond in the rough” and trust each of us enough to allow us to become charter members in the exclusive club known as the elective cosmetic surgical practice. For many of us, the first step in this transforming process is the implementation of a skin care program. The concept of skin care, although not new to the arsenal of the plastic surgeon, has transitioned itself from a feel-good application of lotions and potions to an effective means of (1) preparing and repairing tissues in the perioperative setting, (2) gaining moderate aesthetic results with less invasive procedures, (3) increasing the office traffic of potential cosmetic surgical patients, and (4) potentially becoming an independent source of alternative (nonsurgical) revenue. Cosmetic Dermatology by Leslie Baumann, M.D., is a concise, easy-to-read text that is geared toward the plastic surgeon or dermatologist who has a working relationship with a spa, supervises aestheticians in his or her office, or is generally interested in the science of skin care.
The book is divided into five sections, beginning with an overview of skin anatomy and physiology. The first two chapters focus on the components of the epidermis and dermis and also contain several inferences as to how the ensuing chapters all relate to the basics of skin science. This section continues with a discussion of how cigarette smoking and hormonal changes influence skin aging. It is then completed with a review of dry skin, sensitive skin, and hair loss. After a brief section on skin disease (acne and pigmentation disorders), the majority of the book then focuses on cosmetic science and “dermatologic” procedures.
The chapters on sunscreen, retinoids, and moisturizing agents pay attention to mechanism of action, the means of delivering the active agent, and finish with a discussion of possible side effects. An assessment of the various depigmenting agents is then followed by a thorough review of free radicals and antioxidants. We are then exposed to the more common in-office procedures (microdermabrasion and Endermologie) and are also given the author’s thoughts on the applicability of alternative and herbal medicine to skin care.
The hot topics of botulinum toxin, soft-tissue augmentation, chemical peels, and hair removal therapy are presented adequately, with mention of the indications, contraindications, and alternatives to these procedures. These chapters also contain a number of anatomic diagrams as well as relatively consistent pretreatment and posttreatment photographs for documentation. The text comes to completion with a look at the future of skin care (bioengineering, “cosmeceuticals”) and finally closes with a dialogue on image issues, including piercing, tattooing, and body dysmorphic disorder.
Overall, I found Cosmetic Dermatology to be a well-written guide for those of us who either perform or oversee the performance of skin care. Although the majority of the information is presented in somewhat simplified terms, there are abundant references at the end of each chapter if one desires a more detailed, scientific analysis. This text would also be useful for aestheticians who desire to appreciably expand their data base.