Book Review
Aesthetic Surgery Journal
32(2) 252­–253
© 2012 The American Society for
Aesthetic Plastic Surgery, Inc.
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William P. Adams Jr., Breast Augmentation, Columbus, OH:
McGraw-Hill, 2010.
ISBN-13: 9780071606431. ISBN: 0071606432.
Reviewed by: Claudio Cardoso de Castro, MD
DOI: 10.1177/1090820X11433816
On the first page of Breast Augmentation, author Dr.
William P. Adams Jr. outlines the idea behind the textbook:
“The target audience is any plastic surgeon who desires to
take the practice of breast augmentation to the next level for
their patients.” Dr. Adams reaches that audience through 10
chapters describing preoperative preparation for breast augmentation procedures (such as patient education and the
choice of prostheses), operative techniques, postoperative
protocols, complications, and revisionary surgeries.
The submammary, transaxillary, and periareolar
approaches are described in detail, including how and
where to place the incisions, how to prepare the pocket,
and how to properly introduce the implant. Clinical
“pearls” are identified for each approach, including pitfalls. In these sections, issues concerning the pocket and
the pectoralis major muscles are taken into account, and
recommendations are made for bloodless dissection.
Attention is also paid to correctly identifying the anatomical structures in the region. With every approach, the
author emphasizes the need for care in dissecting the lateral border of the pectoralis major muscle, and he discusses
the challenges of this muscle dissection. Complications
such as capsular contracture, asymmetry, inframammary
malposition, and rippling are individually discussed,
including information about etiology, prevention, and
treatment or revision.
The chapter on postoperative care is particularly interesting. In this chapter, postoperative exercises are described
that can help patients resume normal activity in a very
short period. In Brazil, where I am from, most surgeons
recommend the use of a postoperative compression bra for
a longer period than that indicated in this textbook; they
also recommend limiting postoperative arm movement.
Massage of the prosthesis is encouraged postoperatively
from the second week forward, and patients are instructed
to sleep in the prone position when comfortable enough to
do so. Furthermore, in my country, although a high percentage of women undergo breast augmentation, we do
not place saline prostheses, and we prefer the periareolar
approach. Also, our implant of choice is textured and high
profile. The average implant size is approximately 250 cc.
Anatomical implants are placed infrequently for the reasons that the author refers to in this book—first, if the
implant changes position, the result will be compromised;
second, when the patient is standing, a round implant may
have the same appearance as an anatomical one, and
some anatomical implants appear round when the patient
is supine. A large number of Brazilian plastic surgeons
recommend placing polyurethane-covered implants to
avoid capsular contracture. I personally prefer texturedsurface implants. Also, most surgeons in Brazil favor retromammary implantation; however, I think the idea of
using the dual plane when the patient has little tissue in
the upper pole of the breast is excellent. I place implants
retropectorally when revision is required due to capsular
contracture.
One disadvantage of the book is that most of the figure
legends are embedded within the text, rather than appearing below the images themselves, where they would have
been easier to find. It would also have been helpful for the
clinical preoperative and postoperative photos to include
information about the type and size of implants, along
with the age of each patient. In describing complications,
the author gives much more attention to those experienced
with an inframammary approach, and I found myself
wishing for more information about how to address complications with the transaxillary approach during both
primary and revision surgery.
Dr. Cardoso de Castro is a Professor at the University of Rio de
Janeiro, Rio de Janeiro, Brazil.
Castro253
A DVD accompanies the book, and it shows in detail
the techniques for implant placement through the
inframammary and the transaxillary approaches but not
the periareolar approach.
In summary, Breast Augmentation is an excellent textbook that will undoubtedly be an asset to the younger
plastic surgeon learning how to perform augmentation
procedures; it will also be a resource for more experienced
surgeons looking to improve their skills.
Disclosures
The author declared no potential conflicts of interest with
respect to the research, authorship, and publication of this
article.