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The minute you get away from fundamentals—whether its proper technique, work ethic or mental preparation—the bottom can fall out of your game, your schoolwork, your job, whatever you’re doing.

Get the fundamentals down and the level of everything you do will rise.

—Michael Jordan

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Only the very lucky discover the keystone.

—Wallace Stegner, Angle of Repose

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Cutaneous reconstructive and aesthetic surgery has experienced a meteoric evolution. Intricate flap and graft procedures have been developed to restore surgically affected patients to a normal, unoperated appearance. These techniques have enjoyed wide exposure in manuscripts, textbooks, and professional meetings. And yet, as innovative as these procedures may be, their ability to re-create normalcy will fail dramatically unless meticulous attention is paid to the keystone of surgical fundamentals—suture technique. Unless the scars are intrinsic to tissue movement and transfer approach, the ideal of invisibility, a reconstructive procedure will not be fully restorative, only partially corrective. Whatever marvels of repair have been achieved, all the patient and the outside observer will see and appreciate is the visibility or lack thereof in the resultant scar. Without meticulous attention to this fundamental, the optimal end point will not be achieved. Sadly, attention to the details of suture technique has to date taken a backseat to the glitz and appeal of flap and graft dynamics and aesthetic procedures. Only single chapters in textbooks and rare journal articles are available to detail the broad suturing armamentarium available to the surgeon. Fortunately, with this atlas, Dr. Kantor has superbly filled a void that has not yet been addressed—the keystone of cutaneous surgery—suture technique.

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Dr. Kantor’s passion for this topic is readily apparent. Techniques that are familiar to most and some with which many are unacquainted are equally explored in comprehensive detail. All methods include discussion of application, suture material choice, and procedure mechanics. Unique to this atlas are? Dr. Kantor’s tips and pearls for each technique as well as the caveats of drawbacks and cautions. Each method is diagrammatically illustrated and supplemented by online videos.

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It is not an exaggeration to say that this atlas is unique and innovative. There is no other reference that explores this topic with such detail, clarity, and comprehension. For those of us attempting to provide our patients with the very best that reconstructive and aesthetic surgery can offer, this atlas is invaluable. We owe Dr. Kantor a huge debt of gratitude for sharing his expertise and passion.

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Leonard Dzubow, MD
Former Professor and Director of Mohs and Dermatologic Surgery
University of Pennsylvania
Philadelphia, Pennsylvania
Private Practice, Media, Pennsylvania

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