ince 1985, it has been my privilege to be the Director of The - ciety of Byron Smith Fellows. During the years in which Byron SSmith was with us, his former fellows would meet at the Ame- can Academy of Ophthalmology's annual meeting. They would present to him, and to one another, interesting cases of their own compli- tions that had occurred or cases that had been sent to them that were complications to be repaired. This forum provided the fellows with an excellent format for evaluating their own problems and also for d- cussing how to treat extremely difficult cases. Shortly after Dr. Brian Brazzo completed his fellowship with me in 1998, he asked if I thought it would be appropriate for him to edit a new book on complications of ophthalmic plastic surgery. Certainly, during his fellowship, it became apparent that Dr. Brazzo was pr- ably the most gifted academician and writer that I had ever had the pleasure of training and meeting. I could think of no one more - propriate to continue the work initiated by Dr. Byron Smith and c- ried on by his students.

A number of vital therapeutic modalities are not covered adequately in current dermatology textbooks. This book is intended to fill that gap. It originated in a series of special lectures on modem applications of physical modalities given at recent annual meetings of the American Academy of Dermatology; the main topics were radiotherapy, electrosurgery, phototherapy, cryosurgery, and related therapeutic modalities. The authors, recognized authorities in their field, have included much addi tional information which could not be covered in the original lectures because of time limitations. The indications for modem dermatological x-ray therapy reflect the basic views of the recently published guide lines of the National Academy of Sciences-National Research Council. Both text and illustrations are oriented toward the practical aspects of therapy with physical modalities. A special effort was made to bring the contributions up to date; pertinent references have been added for those who wish to pursue particular topics still further. Where there is an apparent overlap between chapters, it was felt to be advantageous because different authors approached their subject from different perspectives. I am most grateful to the various authors who generously contributed despite their many other commitments. I wish, also, to thank the staff of Springer-Verlag for their advice and assistance in the preparation of the manuscript."

Sexology as a discipline has had to fight for full-fledged recognition in the scientific community. Yet special knowledge of normal and disturbed sexual behavior is expected of medical professionals, psychologists and educators alike. Based on the papers given at the 8th World Congress for Sexology in 1987, this volume gives an up-to-date discussion of the most interesting and controversial topics, such as AIDS, in the field. Contributions have been grouped under the main headings: Family Planning, Sterility and Sexuality, Erectile Dysfunction, Sexuality in the Elderly and in Marriage, Transsexualism, Sexual Therapy, and Sexuality and Illness, and include items of historical interest as well as transcultural comparisons.

This volume is dedicated to the Third International Symposium on Microneurosurgical Anastomoses for Cerebral Ischemia, which took place in Rottach-Egern, June 2&-30, 1976, under the sponsorship of Professor F. Marguth, Director of the Depart- ment of Neurosurgery, Ludwig-Maximilians-University of Munich (West Germany). It contains the continuing devel- opments of the extra- intracranial arterial bypass (EIAB) for cerebrovascular occlusive disease since the First International Symposium in Lorna Linda, California, in June, 1973, and the Second International Symposium in Chicago, Illinois, in June, 1974. The EIAB was developed by Donaghy and Yasargil, and it consists of a microsurgical anastomosis of the superficial tem- poral artery or the occipi tal branch of the external carotid artery to the middle cerebral artery on the surface of the brain and, very recently, the anastomosis of the occipital artery to the posterior-inferior cerebellar artery for the treatment of verte- brobasilar insufficiency. From the presentations at the sym- posium it became evident that the greatest potential in the pre- vention of a stroke in a susceptible patient is the presence of an adequate collateral cerebral blood flow. The basic diagnostic procedure is cerebral angiography in- cluding both carotid and vertebral arteries. Regional cerebral blood flow (rCBF) studies and computerized tomography add further diagnostic information and are particularly important in the selection of potential surgical candidates.

The skin allograft has been used as the test tool since the beginning of investiga tions of the fate of skin transplanted between two individuals of ordinary genetic diversity. This monograph is designed to furnish the transplantation work er with a review of the significant papers in which skin allografts and xeno grafts, applied to experimental animals and man, have played a role in acquiring a body of knowledge concerning the behavior and fate of these transplants and the reaction of the body to their presence. Skin, an essential organ for survival, a barrier between the "milieu inte rieur" of Claude Bernard and the "milieu exterieur," will remain the most frequently used transplant in transplantation research. Because it is highly antigenic, the final solution of the problem of acceptance of allografts of various tissues and organs will probably depend upon the achievement of a permanent survival of skin allografts. My personal interest in transplantation, which originated during my surgi cal training, was rekindled when I met Peter Medawar (today Sir Peter) in England during World War II. I had joined, in 1940, an American Volunteer Surgical Unit (The American Hospital in Britain), organized and headed by Dr."

Reconstructive microvascular surgery is now in its teens. At first many thought this new child was a whim and would fail to thrive. Some were un certain, others with vision either supported or became actively involved in this new area of surgical endeavour. Although initial interest was focused on the replantation of amputated parts, it has been the one stage free trans fer of living tissue to a distant site which has launched microsurgery into the surgical spotlight. From its humble beginnings we have witnessed a revolution in this branch of plastic surgery; many of the long established methods of recon struction have, like barricades, fallen before the advances made in this field. In its infancy there were relatively few procedures available. There was a tendency to make the patient's problem fit the operation, rather than the reverse, and this frequently led to an inferior result. The then known flaps, such as the groin flap and the deltopectoral flap, were employed. Unfortunately they were sites which posed many technical problems; namely those of vascular anomaly, a short pedicle and vessels of small cal ibre. Long operations were the norm, and vascular thrombosis was not un common. Hospital routine often was disrupted and there was a danger that these new techniques would fall into disrepute. Over the last decade this state of affairs has changed dramatically.

Distraction osteogenesis is a technique of bone lengthening developed by the late Dr. Ilizarov of Russia. It has been applied to the lower extremities with amazing success for the correction of non-unions following fractures as well as underdeveloped limbs. Dr. McCarthy and his colleagues at NYU have developed techniques of distracting various components of the craniofacial skeleton. These techniques hold considerable promise for reconstructive surgery, allowing the surgeon to make precise changes in the lenthening and shape of the new craniofacial bone. This volume is the first book of its kind, bringing together the pioneers of these revolutionary new techniques. An international group of experts present their clinical and laboratory experience with destraction of the cranial vault, orbit, midface and zygoma, and mandible, as well as the prinicples of distraction, biomechanics, and the physiology of bone healing and remodeling. Two hundred illustrations elucidate the techniques. This book is a must for all reconstructive plastic surgeons, maxillofacial surgeons, and oral surgeons.

Practical Procedures in Aesthetic Plastic Surgery, written by one of the foremost authorities in the field, is the definitive "hands-on" guide for the practicing plastic surgeon. Each chapter presents the actual execution of a specific surgical technique and illustrates the finer points that separate unacceptable from state-of-the-art surgical results. Aesthetic plastic surgery procedures from head-to-toe are covered, including blepharoplasty, rhytidectomy, abdominoplasty, suction-assisted lipectomy, breast augmentation, and lip enhancement. Over 500 photographs and line drawings, with 46 in full color, are the thrust of the book's benefit to the practicing surgeon, as each clearly defines the technical maneuvers essential in achieving flawless results. Prevention of mistakes as well as correction and repair of poor technique are also emphasized - an area that few books stress at all. Truly the most clear-cut technical volume available, this book should be in the hands of all practicing plastic surgeons and residents.

In thc space of ooly a few years, reconstructive surgery of the skeleton of the hand has become a foeus of attention. Thc reason for this has been the advent of principles and techniques of stable internal fixation, tbc unparaJleled advantages of which are particularly evident in the treatment of the complex, multi- structural lesions so typical of injuries of the hand, and also in procedures such as replantation or revascularisatioss. What a striking contrast on the other hand is to be seen in the slow and painful progress made in Dur understanding of the biomechanics of the radiocarpal joint! This is most elo- quently ilIustrated by the embryonie state of prosthetic surgery of the wrist, compared with the sophisticatcd advances made in hip and knee surgery. Yet it is undeniable that painful condi- tions involving dysfunctions of the wrist are increasing in number and affect young people in particular; this should spur us on to seek more effective therapeutic solutions.

Several years ago Coleman (1981) reported that in 1979 one of the many in ternational cosmetics companies had an annual sales figure of $2. 38 billion, nearly 1. 25 million sales representatives, and over 700 products, the majority of these being for the face. Cash and Cash (1982) noted that in 1979 U. S. consumers spent over $4 million on cosmetic products. They stated that, "Although this practice would seem to be a fascinating aspect of human be havior on the basis of its generality and resilience, social-behavioral scientists have largely ignored the phenomenon so plainly (or pleasingly) in front of their eyes. " Why should people be so concerned with their facial appearance? Many psychologists have argued (e. g., Kleck & Rubenstein, 1975) not only that facial information is usually the first that is available to the perceiver, but also that it is continuously available during social interaction. Maruyama and Miller (1981) stated that "appearance is often the first dimension upon which a stranger can be evaluated. Since people tend to see others as integrated and consistent units, rather than as collections of situation-specific behaviors, a potent and immediately evident basis for an evaluation, such as physical appearance, should intrude into and affect any overall and subsequent evalua tion."

In 1958;a severely burned steel worker, the extent of whose bums was 890/0 of the body surface, with 20070 of third degree bums, was saved by the Kwangts'e hospital (now the Rui Jin hospital) of Shanghai Second Medical College. It was the first report in the world of such a critically injured patient recovering, and seemed like a miracle at that time. During the 24 following years, a great number of papers reporting the development and advances in bum therapy in clinics and in research showed that Chinese medical investigations in the field of bums have ranked among the most advanced in the world. Plastic surgery, as an independent branch of general surgery, has been established gradually since Liberation. Recently, new techniques, including microsurgical techniques, in plastic surgery have emerged and developed, permitting rapid progress in clinical work and attracting attention and appreciation in other parts of the world. The first national congress of Burns and Plastic Surgery was held from May 16-24 1982 in Shanghai. Over 800 papers were presented and showed how advances have been made in recent years in these two specialities. Here we present selected articles as a symposium. It is hoped that this symposium will be of value to its readers. About the Editors Chang Ti-sheng (Zhang Di-sheng), who was born 12 June 1916, is Professor of Surgery, Shanghai Second Medical College, Shanghai, Chief of the Department of Plastic and Reconstructive Surgery, and Director of Shanghai Ninth People's Hospital, Shanghai.

Preclinical experimental transplantation research that is based on microsurgical models in rats fulfills two indispensable conditions for modern organ transplanta tion research: Almost all organ grafts can be performed on the rat with an amount of technical effort that is still justifiable. Thus transplantation models that are analogous to human organ transplantation can be developed, tested, and evaluated. This fulfills a necessary condition from the standpoint of surgery. With the species rat, we have a great variety of genetically different inbred strains. From the immunological point of view this is an indispensable prerequisite for the investigation of preclinical transplantation models that can be expected to produce controllable, reproducible results. In vivo experimental results can be supplemented by and correlated to in vitro tests. Lately these experimental results are being greatly expanded and more precisely defined by the application of immunohistological methods that have been established recently in Kiel. In this book we hope to present a cross section of the microsurgical models in use today and of current immunological and immunohistological models. Furthermore, we wish to record the present state of microsurgical organ transplantation research and to show its relationship to the current state and development of clinical organ transplantation. A special aspect of our Kiel research group is the long-term, well-functioning, interdisciplinary cooperation between surgery, immunology, and pathology. Through this cooperation we attempt to provide an atmosphere in which theoretical and practical viewpoints can mutually influence each other."

This book has been assembled from the radiographic and photo graphic records of patients presenting to craniofacial units on four continents over 7 years. It is our purpose to illustrate a wide range of craniofacial deformities with the technique of three-dimensional com puted tomography. Many topics are briefly addressed with descriptive text intended to amplify the accompanying images but not to exclude the need for more comprehensive references as recommended in the reading list of each chapter. The ability to generate three-dimensional radiographic images rep resents a successful integration of computed tomography with com puter graphics. Although this technique remains an electronic substi tute for the study of dry skull specimens, it offers a permanent pictorial record of anatomical structures with the opportunity for fu ture interactive data manipulation. It is hoped, therefore, that this work will assist others to gain a more complete understanding of disorders of the craniofacial region. We encourage other surgeons and investigators to examine and employ the techniques used to gather these images but also to ensure that standardized scanning regimens are adapted. The importance of data collection within its full anatomical context was borne out with many of our early studies, which were limited owing to computational con straints. Often an image requirement for surgical intervention is much less than an image necessary for strict scientific inquiry."

Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later."

Here, one of the most respected otoplasty surgeons has written the definitive book on the latest techniques. Jack Davis brings the plastic surgeon and the otolaryngologist up to date with the newest concepts and methods for reconstructive and aesthetic plastic surgery of the ear. The volume contains such hot topics as secondary otoplasty, "eplasty", "sandwich" methods, radical auriculoplasty and stereotaxic surgery, but also covers histogenesis and growth of cartilage, auricular functional properties and embryology of the external ear. With the authors own beautiful drawings and preceded by a foreword by Dr. Blair Rogers, Otoplasty: Aesthetic and Reconstructive Techniques will undoubtedly fill an important niche in the market.

This comprehensive volume examines the possible complications that can arise in cutaneous surgery. The demand for outpatient cutaneous surgery procedures has increased at a rapid rate over the last several decades. As the number of cutaneous surgery procedures rises, so will the rate of complications, which are inevitable and occur even with the most skilled, careful, and meticulous surgeons. This work will help the practicing physician to formulate a preoperative strategy that will prevent complications before they occur as well as properly diagnose and manage complications if they arise, allowing the physician to provide optimal care to the patient.

...fungar vice cotis, acutum reddere quae ferrum valet exsors ipsa secandi (HORACE, .Ars poetical Era da prevedere che dopo parentesi assai lunga di silenziosa elaborazione, al grande sviluppo della chirurgia plastica ed al suo affermarsi come "specialita) generalmente riconosciuta, seguisse la fioritura di testi vari di mole e di intenzione a quella dedicati. Lodevoli opere quasi tutte ma per la maggior parte riflettenti massima la preoccupazione degli autori di esibire i piu brillanti risultati raggiunti anzicM indicare con sufficiente chiarezza e dettaglio i mezzi piu idonei a conseguirli. Ma ecco finalmente uscire per Ie stampe questi volumi splendidi di veste dove gli Autori, pur valentissimi chirurghi, quasi dappertutto rinunciano a far bella mostra di se col fotografico sciorinamento di quanto pur sanno fare ed invece con modestia pari a quella dell'antico Poeta esporre ogni piu riposto dettaglio di interventi fondamentali 0 menD comuni valendosi del sussidio di figure di rigorosa rispondenza e di insuperata artistica efficacia. Opera questa destinata ad imporsi ed a rimanere proprio percM di essa puo farsi il raro elogio d'essere veramente strumento di lavoro cui tanti chirurghi non mancheranno di fare frequente ricorso onde affinare la propria esperienza proprio come Orazio pensava dovesse essere dell'opera sua.

After 20 years of intense and gradual improvements in the practice of craniofacial surgery, the International Society was born in Montreal (June 1983) and I. Munro was selected as general secretary. Its first meeting was held in La Napoule (Sep tember 1985) under the chairmanship of D. Marchac. In the meantime, the Euro pean group of the Society had held a session in Stockholm (June 1985) with B. Jo hanson acting as chairman. This now belongs to the history of our specialty, as does the course organized by E. Caronni in Rome (March 1982). These four landmarks in such a short time show the lively interest in craniofacial malformations and all their correction involves: - Syndrome delineation - Evaluation of the components of the malformations - Anatomy of the malformations - Imaging and measurement - Strategies and tactics in very different syndromes - Follow-up with reference to growth patterns in patients subjected to surgery or merely kept under observation - Implications of orbitocranial procedures for routine maxillofacial surgery - The interdisciplinary approach involving pediatricians, anesthesiologists, n- rosurgeons, ophthalmologists, orthodontists and speech specialists - The theories in vogue and those revised for some of the abnormalities All this could not be resolved in a 2-day meeting and probably will not be solved in the next generation."

In recent years wrist problems have increasingly attracted the attention of orthopaedic and hand surgeons. Numerous advances have been achieved in functional anatomy, biomechanics, diagnosis, and treatment. There are, however, many controversial aspects to these problems. Many clinical and associated investigators from around the world have attempted to increase our knowledge of the wrist with enthusiastic and devoted studies. An international symposium was held at the Nagoya Castle Hotel, Nagoya, Japan from March 6th through March 8th, 1991 to further understanding and promote discussion of wrist problems among a representive international group. Approximately 300 participants from 16 different countries assembled for these discussions. This monograph consists of 40 selected papers based on presentations given at the international symposium. The topics are divided into six chapters: Functional Anatomy, Diagnosis and Basic Studies; Kienbock's Disease; Scaphoid Fracture, Distal Radius Fracture; Carpal Instability and Wrist Pain; and Wrist Arthroplasty. A number of unique observations as well as detailed surgical techniques were presented. These include topics such as the vascularity of the triangular fibrocartilage, radial wedge osteotomy and vascular bundle implantation into the lunate for Kienbock's disease, Herbert screw insertion though a minimal exposure for acute scaphoid fracture, and closing wedge oseotomy of the radial styloid for the early stage of the SLAC wrist. It is hoped that this monograph will be of benefit to surgeons interested in not only achieving more satisfactory clinical outcomes, but also in stimulating further contemplation and research about these difficult wrist problems.

The introduction of the operating microscope as a surgical tool revolutionized the treatment of peripheral nerve lesions. A new era thus began in the early 1960s, which led to a substantial improvement in the management of nerve lesions. The results of nerve grafting techniques have demonstrated that, independent of the length of the defect, lesions can be successfully bridged. The free tissue transplants with microvascular anastomosis have also opened new, rewarding possibilities for peripheral nerve reconstruction procedures, facilitating the achievement not only of satisfactory anatomical but also of satisfactory fUhctional results. In order to evaluate the state of the art and reflect retrospectively on 25 years of microneurosurgical treatment of peripheral nerves, numerous outstanding scientists and clinicosurgical physicians were invited to Hanover in order to exchange their viewpoints and experiences. An active und fruitful discussion resulted which dealt with the many aspects of anatomy, pathology, clinical and neuro physiology, diagnosis, and with the surgery and physiotherapy which constitute modern-day peripheral nerve lesion treatment. The excit ing ongoing experimental and clinical activities have led us to support the wish and idea to publish the scientific exchange which took place during the Hanover symposium. I truly believe that the articles presented in this book cover so many interesting subjects concerned with peripheral nerve lesions that the book will serve the interested and dedicated physician involved with such cases as a reference work for the basics and also provide him with the therapeutic guidelines to assist him in his daily work."

The exponential growth in the number of research papers published in recent decades can make it difficult to identify the key papers that have truly made a difference in the practice of oral and maxillofacial surgery. This book provides readers with a concise reference source for the key papers that underpin contemporary surgical practice in oral and maxillofacial surgery. Covering all aspects of the specialty, the content will help both trainees and specialists to understand the scientific developments and pioneering surgeries that allow us to practice as we currently do. It is essential revision material for those sitting for specialist examinations in oral and maxillofacial surgery. + Presents 50 key research studies on surgery along with full analysis + Additional commentaries from the original authors, experts or editors - providing a valuable perspective on why the study is important + Constitutes essential reading for trainees, residents and fellows, and surgeons studying for professional examinations + Distills all the literature into a compact guide on the must-know scientific articles About the Editors Niall MH McLeod FRCS (OMFS), FDS, MRCS Consultant Oral & Maxillofacial Surgeon, The Royal London and Whipps Cross Hospitals, London, UK Peter A Brennan MD, PhD, FRCS, FRCSI, FDS Consultant Maxillofacial Surgeon and Professor of Surgery, Queen Alexandra Hospital, Portsmouth, UK

The scope of dermatologic surgery is so wide that inevitably a large number and variety of complications arise. Of course the majority of complications can be prevented by careful preoperative preparation, meticulous surgical technique, and proper postoperative care, but when they do occur, they can be recognized and managed with skill and competence. This book provides a valuable source of reference for the prevention, recogni tion, and management of complications in dermatologic surgery. Avoiding pro blems is at least as important as dealing with them, and so all the chapters in this book deal with both prevention and management. This book addresses dermatologic surgeons in practice or in training and to surgeons in other specialties who may be required to undertake repair of skin defects. Many ofthe authors accepted the responsibility of contributing to this work in addition to their many other obligations. For this, I am extremely grateful to them. MARwALI HARAHAP Contents Local Anesthesia and Regional Anesthesia George B. Winton ...................................................... 1 Electrodesiccation and Curettage Harvey Finkelstein and Robert Jackson. . . . . . . . . . . . . . . . . . . . . .. . . . 16 . . . . . . . ."

The greater the poverty, The stronger the will. In the face of hardship, Soar, soar, soar on still WANG Bo (650-676 A.D.) In the late spring of 1958 a patient was admitted to Rui Jin Hospital with extensive burns; just minutes before he had been dexterously operating one of Shanghai's" productive converters" used in the making of steel. He resembled a mass of charcoal but was mentally alert, asserting that he must survive, not only because of the great expectations he had of life but also to con tinue working in his beloved post as first-generation steelworker in this newly liberated country. The case presented a stern challenge; faced with this man yearning both for his own life and for that of the society in which he lived, we had no way of escaping either "poverty" (in the form of our limited facilities) or hardships. However, by pooling all our efforts we were able to ensure that the patient ultimately survived the extremely tortuous course that followed, in addition to which quite good functional recovery was achieved. So began our burn unit. It was on this patient that we performed for the first time artificial hibernation (in the treatment of burns), early eschar excision, repeated autos kin cropping, and allografting. Not only were these the decisive measures which helped our patient to achieve his professed intention, but they also gradually evolved to become the characteristics of our present-day treatment.

Covers the immediate assessment and management of common plastic and reconstructive surgery emergencies and referrals. A companion for junior doctors starting within plastic surgery, the Plastic Surgery for \Trauma provides succinct and clear presentation together with up to date guidelines on the common plastic surgery emergencies. With clear descriptions of difficult trauma scenarios, illustrated with numerous figures, and updated guidelines for each step of practice, this book will ensure that the reader can access all the information required to help gain confidence and experience .Be the readers passing through a plastic surgery rotation on their way to some other career goal or beginning within plastic surgery and keen to make a strong start with a view to progressing in the speciality, this book provides the support to allow rational and confident clinical decision making from the start. Essential reading for all non-specialists and trainees.

All over the world research is going on to improve the outcome of the treatment of peripheral nerve lesions. Yet, there exist many questions, such as: Is the autologeous nerve grafting still the golden standard in bridging defects? Have alternative techniques to overcome defects reached a level to replace autografting? What can be expected from end to side coaptation? The contributions in this book give answers to all of these questions.