Dallas Rhinoplasty: Nasal Surgery by the Masters Edited by Jack P. Gunter, M.D., Rod J. Rohrich, M.D., William P. Adams, Jr., M.D., and Holly Smith, B.F.A. Pp. 1500. Quality Medical Publishing, St. Louis, Mo., 2007. Price: $475.
Rhinoplasty is easily the most challenging of the cosmetic surgery procedures. Over the past 31 years, I have had the opportunity to try my skills several thousand times. Quoting my friend Jack Gunter, whom I have heard make this statement numerous times, “I have never seen a perfect result.” (I have had a few that I thought were close.) The second edition of Dallas Rhinoplasty: Nasal Surgery by the Masters, edited by Drs. Jack P. Gunter, Rod J. Rohrich, and William P. Adams, Jr., is written for the surgeon who wants to achieve that perfect rhinoplasty result.
The Dallas Rhinoplasty Symposium was the brainchild of world-renowned rhinoplasty expert Jack Gunter, who wanted a forum for surgeons of various disciplines interested in mastering rhinoplasty where they could share thoughts, ideas, and techniques to advance the art. This symposium has now had 24 years of success. I have had the honor of participating as a faculty member in this superb learning experience in Dallas.
The second edition of Dallas Rhinoplasty is an expansion of the first edition, which provides a comprehensive approach to basic and advanced open rhinoplasty techniques with an emphasis on anatomy. The second edition now consists of two volumes in 72 chapters (32 of which are new to this edition) that are written by 59 knowledgeable surgeons from around the country. There is meticulous descriptive information on anatomy, analysis and planning of surgical treatment of the nasal tip, nasal dorsum. and septum, and more advanced techniques to address secondary rhinoplasty, traumatic deformities, and the deviated nose.
The original chapters have been updated and new ones added to provide complete coverage of this constantly involving subject. The new chapters, all on special topics, discuss autospreader grafts, septal extension grafts, management of the chin, and treatment of the cleft lip nose as well as noses of various ethnicities. Dr. Gunter’s color-coded graphic diagrams, which have become the standard in demonstrating how a rhinoplasty is performed, illustrate the treatment plan for each case. Each chapter provides visibly highlighted key points for rapid review and reference. The final section offers the personal approaches and philosophies of seven leading rhinoplasty surgeons.
In the Preface of the second edition, Drs. Gunter, Rohrich, and Adams note that “although this book has grown as information in our field has expanded, our objectives remain the same–-to assist the nasal surgeon in obtaining constant results using careful preoperative analysis, precise operative planning, meticulous intraoperative execution, and long-term follow-up with critical evaluation of results.” For the most part, the editors will more than achieve their objectives. However, most of the patients presented in the text were not long-term follow-ups, which is of interest when one considers the changes that occur over time after rhinoplasty. The vast majority of noses are shown less than 2 years postoperatively, with an occasional longer-term result shown; experienced rhinoplasty surgeons are well aware that the nose changes for many years after surgical procedures and that results that appeared satisfactory in the first couple of years may give a different appearance with the passage of more time.
One last point is that while the text has encyclopedic coverage of open rhinoplasty, closed rhinoplasty is addressed primarily in the chapter by Dr. Mark Constantian. He discusses his thoughts and technique in detail. Only brief mention is given to closed rhinoplasty by other authors.
Dr. Jennifer Walden, my associate, also reviewed this book. I thought it would be interesting to see whether the 29-year difference in our practice experience would color her opinion. She felt that this text offered to the young surgeon a welcome thread of consistent nasal terminology, principles and guidelines for functional evaluation and preoperative planning, and detailed surgical technique for the open approach. She noted that if she were ever hesitant about a particular plan for a nasal procedure, the text would offer reassurance in the pragmatic approach to the diagnosis, planning, and execution of this challenging surgical procedure.
In addition to the text, there are three accompanying must-see CD-ROMs: “Cadaveric Demonstration of Rhinoplasty Techniques,” by Rohrich, Gunter, Hollier, and Janis; “Open Approach to Primary Rhinoplasty,” by Rohrich, and “Secondary Rhinoplasty: Using Autologous Rib Cartilage,” by Gunter and Yu.
In summary, my associate and I believe that the second edition of Dallas Rhinoplasty is an exceptional textbook. It should be owned and used frequently by any surgeon who performs rhinoplasty, regardless of his or her years of surgical experience.
Sherrell J. Aston, M.D.
Jennifer L. Walden, M.D.
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