I do not know who Joe Niamatu I or Joe Niamtu II were and sadly I have never met Joe Niamtu III. I have, however, read his book from cover to cover and feel that I got to know his wonderful quirky, but very honest and open personality, and I look forward to meeting him in person. The book seeks to review and explain his experience of decades of experience in facial cosmetic surgery.

There are excellent chapters on facial ageing, facelifts, brow lifts, blepharoplasty, rhinoplasty, otoplasty, implants and the many aspects of non-surgical rejuvenation. I found the face and neck lifting particularly well written and constructed. It gives clear, experience-based guidance on assessment, planning, execution and care of facelift patients. A must surely for every surgeon starting a career in facial aesthetics. There is no attempt to make claim to this being an evidenced-based text.

The message is largely focused on the accumulated experience of the primary author and other than ‘suggested reading’ doesn’t pay much homage to the alternatives suggested by others. But in many ways therein lies its beauty, for the text is easy to follow, the anecdotes amusing, the tips and tricks and videos invaluable for the novice and the photographs are concise and to the point. I did find the rhinoplasty section a little disappointing. I can see that whilst the facelift chapter provides insights and knowledge necessary to embark on surgery the rhinoplasty chapter was a little more superficial and lacked the depth of description required to ‘get to grips’ with the subject.

I also found some of the claims made in the otoplasty chapter a little contentious. Without doubt the suggestion that early otoplasty surgery (age four) is advantageous reflects North American bias but the fact is there is no evidence base to substantiate better psychosocial or surgical outcomes with early surgery compared to age 8-10. This indeed is typical of one of the trade-offs in this text. The personal, non-evidential approach makes it easy and enjoyable to read but un-substantiated claims carry some risk. Who was it that said “That which can easily be asserted without evidence can be easily dismissed without evidence”? But on the whole, this is a great book. I loved every minute of reading it and I look forward to buying the good Dr Joe Niamtu III a beer.

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Ken Stewart

NHS Lothian, UK.

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