problems-in-breast-surgery-a-repair-manualEditors: Jack Fisher, MD and Neil Handel, MD
Publisher: Thieme – 834 pages
Book Review by: Nano Khilnani

A ‘repair manual’ is an interesting and humorous term to use in the title of a medical book, but after looking at some of the pictures and reading the ways the problems were solved in this ‘fix-it’ manual, I was sold on its value for surgeons and patients alike.

Here are some things to consider if you a prospective patient:

A woman would certainly be disappointed if one of her breasts had become smaller (deflated) after she had undergone a procedure in the past to enlarge (augment) her breasts. This requires a ‘repair job’ certainly, to make both breasts look even. This book shows the surgeon the solution to that problem.

Or when a woman noticed that her left-side breast was lower than the one on the right side. That certainly requires an adjustment. This book provides the how-to.

A common problem for women is sagging breasts, which make them look small. While there are bras in the market that uplift breasts, or have some filled-in material, some women simply want breasts that look normally firm. This book shows how that can be achieved.

Some breasts may simply be ‘unfixable’ and have to be replaced with implants. But there are just so many available options that it is difficult decide what to do. This book provides the pros and cons for surgeons and patients to make the right decision.

From the perspective of a breast surgeon, he or she needs knowledge, experience, developed skills, as well as insight to help patients with the problems mentioned above, as well as numerous others that they would encounter in his or her practice. They may not have these resources at sufficient levels. This book helps fill those needs and gaps.

Thirty specialists from around the United States and three other countries – Belgium, Canada, and France – wrote the 49 chapters of this book, which are allocated in six Parts named below, that provide you an overview of what is covered in this unusual ‘breast repair and replacement’ guide.

  1. Part I – Fundamentals    
  2. Part II – Problems in Augmentation Mammaplasty
    1. Section 1: Postoperative Complications
    2. Section 2: Suboptimal Aesthetic Outcomes
  3. Part III – Problems in Mastopexy and Augmentation-Mastopexy
    1. Section 1: Postoperative Complications
    2. Section 2: Unsatisfactory Aesthetic Outcomes
  4. Part IV – Problems in Reduction Mammaplasty
    1. Section 1: Postoperative Complications
    2. Section 2: Suboptimal Aesthetic Outcomes
  5. Part V-A – Problems in Breast Reconstruction With Prosthetic Devices
    1. Section 1: Postoperative Complications
    2. Section 2: Suboptimal Aesthetic Outcomes
  6. Part V-B – Problems in Breast Reconstruction With Autologous Tissue
    1. Section 1: Postoperative Complications
    2. Section 2: Suboptimal Aesthetic Outcomes
  7. Part V-C – Deformities Associate With Lumpectomy, Partial Mastectomies, Radiation
    1. Section: Complications and Suboptimal Aesthetic Outcomes
  8. Part V-D – Cancer Recurrence After Breast Reconstruction
  9. Part VI – Problems Associate With the Nipple-Areola Complex
    1. Section: Complications and Suboptimal Aesthetic Outcomes

As a purchaser of this print edition you can access the E-book version and other valuable resources available for you online. Go to, then:

  1. Create your VitalSource Bookshelf account or log on to it if you already have an account.
  2. Redeem the code by scratching off the grey film on the inside front cover of this book

You can download the E-book version of this book on your PC or Mac, iPhone, iPad Touch, iPad, Android phone or other smart phone, tablet, or on your Kindle Fire. If you have any questions whatever on downloading, please visit:

Surgical procedures do not always deliver the desired outcomes in breast implantation, repair, reconstruction, or replacement. After surgery, one or both breasts may look too small, too large, too low, too high, too loose, too firm, or whatever. Moreover, complications such as these may result: flap failure, implant extrusion, infection, nipple necrosis, or some other undesirable or unexpected outcome.

Corrective breast surgery, which is the primary focus of this text, empowers you the surgeon to use any of a large range of techniques spelled out in this highly useful book. This ‘repair manual’ helps you systematically to:

  • Evaluate the problem
  • Assess the different options available to address it
  • Take into account all the factors that will influence the outcome
  • Formulate a plan

The editors write: “the value of this book comes from clinical judgment and surgical skills of the talented breast surgeons who have shared their experiences and approaches to treating patients with these challenging problems.”

The editors point out that in order for you the surgeon to follow the thought process of the author-surgeon as he or she evaluates the problem at hand, they have used a ‘highly-structured case format’ in which each patient example is organized into eight separate sections, namely:

  1. Patient history leading to the specific breast problem
  2. Anatomic description of the patient’s current status
  3. Analysis of the problem
  4. Recommended solution to the problem
  5. Technique
  6. Postoperative photographs and critical evaluation of the results
  7. Teaching points
  8. Bibliography

Each chapter in this book is organized and presented based on the above eight-point format.

This truly is an outstanding text on evaluating problems in breast surgery, formulating a plan to fix them, and implementing that plan carefully and thoroughly for the desired optimal solution.



Jack Fisher, MD, FACS is Associate Clinical Professor in the Department of Plastic Surgery at Vanderbilt University in Nashville, Tennessee.

Neil Handel, MD, FACS is Associate Clinical Professor in the Division of Plastic Surgery in the David Geffen School of Medicine at the University of California – Los Angeles, in Los Angeles, California.