DOI: 10.1097/01.prs.0000367487.74280.4c
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Issn Print: 0032-1052
Publication Date: 2010/04/01
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Excerpt
By Mark B. Constantian. Two volumes, pp. 1454. Quality Medical Publishing Inc., St. Louis, Mo. 2009. Price: $395.
Rhinoplasty: Craft & Magic is just what you would expect from a masterful rhinoplasty surgeon such as Dr. Constantian. It is well organized and beautifully written and presented, and much attention is given to detail. The amount of information it provides is enormous.
Dr. Constantian has devoted most of his professional life to studying, performing, and teaching rhinoplasty. He had a great advantage in learning this operation under the tutelage of his mentor, Dr. Jack Sheen, a true master and teacher of this operation, and made as many contributions, if not more, to the progress of this operation as any surgeon in recent times. The book is about the philosophy of these two men, formed by their experiences, the results of their studies, and the conclusions they made from them. Almost every conceivable clinical problem about rhinoplasty is covered in this book, and it is amazing the number of cases Dr. Constantian has compiled, documented, and used for explaining the different types of problems.
This book is a complete work on rhinoplasty, starting with the “Anatomy and Aesthetics” chapter and ending on a not-too-pleasant chapter but one that is necessary, “The Unhappy Patient.” In the chapters in between, Dr. Constantian discusses topics that are not written about enough but which every rhinoplasty surgeon should understand, such as “The Anatomy of Function and How Rhinoplasty Affects the Airway,” “Why Rhinoplasty Is So Difficult,” “Problems in Postoperative Care,” “Exceptions to the Usual,” and so on. The weight of the book, however, is about diagnosis, planning, and technique (both basic and advanced), the common problems most often encountered, and secondary rhinoplasty. Add to all of this the voluminous, well-documented clinical and surgical photographs, and a few diagrams, graphs, and charts where indicated, and you have a book that is loaded with information.
Most readers are aware that Dr. Constantian and Dr. Sheen are endonasal rhinoplasty surgeons. It probably makes one wonder why a surgeon like myself, who uses the open approach almost extensively, would be so enthusiastic about this book. The open approach came into being in the United States in the late 1970s and early 1980s. One reason for this was that by then most of the leading endonasal surgeons had recognized not only that rhinoplasty was a reduction operation but also that in many cases augmentation could enhance the results. Rhinoplasty was already a difficult operation, but as more new grafts (e.g., spreader grafts, shield tip grafts, radix grafts, batten grafts, dorsal only grafts, and so on) were discovered, the operation became even more difficult. I cannot say that open rhinoplasty is a better operation than endonasal rhinoplasty, but many surgeons feel more comfortable with the increased exposure it affords. However, if a surgeon is talented enough to do everything that needs to be done and do it well through the endonasal approach, it is probably a better approach to use.
We need to remember that the majority of the basic principles of rhinoplasty and many of the modern-day grafts were developed by endonasal rhinoplasty surgeons. Anyone really interested in performing rhinoplasty should know about these principles, how they were developed, and the grafts and techniques used to place them. This will strengthen the foundation for the developing rhinoplasty surgeon and add to what has already been learned, and continue to make it a more predictable and reproducible operation in the future.
My congratulations on this important contribution.
