the other residents in my program are a lot more critical of this text than i. i agree that it is very inconsistent. some chapters good, some very poor. all do not give a good idea of "outcomes", part of the intent and title of the text. it is mostly a " this is how i do it as i am famous" read. however, i must be fair and admit this is probably the most complete recent text on comprehensive plastic surgery. i do not regret buying it.

An excellent reference for first year residents in plastic surgery, or other surgical residents who want to explore the fascinating world of plastic surgery. The third "great compilation" of the plastic surgery knowledge, who substitutes McCarthy's text ,yet McCarthy's is quite more extensive, but a little out time (1990). This could be any plastic surgeon's pillow book...

This is without a question the definative text of plastic surgery. Just look at the authors. Current comprehensive, and well organized. This is a must own. This book replaces my entire plastic surgery library.

Having read, and mostly loved, all of Irving's previous works, I rushed out to get "The Fourth Hand" the day it was published. I just finished it and I agree with the previous reviewer: this was a real disappointment. In addition to the fact that it's a rather skimpy idea for a novel, the writing seemed extremely amateurish to me. A couple of times I asked myself if it was really John Irving writing.

The book is absolutely larded with cliches: "so to speak," "as it were," "was wont to say," and almost every paragraph ends with a distracting parenthetical aside. Was there no editor on the job?

An even bigger problem is that most of the story is told in a "once-removed" style. There are very few real scenes until the second half. The first half feels like a quick retelling of some other novel. This is especially disappointing from Irving because he has always been the master of storytelling. (Think of the orphanage scenes in "Cider House Rules" or the scenes about Jenny's early days in "Garp.")

If you're a true fan, you'll want to read this. After all, there are glimmers of the real John Irving here -- a scene in which a young lady nearly chokes to death on her chewing gum comes to mind. But wait for the paperback. If you haven't read John Irving before, please don't start here.

I dunno. This John Irving novel just doesn't live up to his previous ones. There are the usual LOL moments, the usual quirky characters, the usual brilliant schticks, but the character development strikes me as weak and hurried - or rather, almost nonexistent. Except for the women, and they steal the show. I know, I know: it's satire, but I'm sure someone of Irving's prodigious gifts and talents can do better with delving into the depths of the human condition. I mean, come on: he's already done it a thousand times over in his previous books.
On the plus side: there're the typical romps through the complicated, twisted, quirky, and inter-twined Irvingesque explorations of all the various relationships involved. TV journalist Wallingford loses his hand to a lion, live on TV, and some fan wills his hand to Wallingford...just in case - and all too soon, he conveniently dies, Wallingford gets the hand, and the widow of the donor wants visitation rights.
Um...yeah, right. Read it and decide for yourself.

See storyline above.

I thought this was kind of a fun book to read. The character of Patrick Wallington as a woman loving reporter, though not highly likable, did grow on you. At times laugh out loud funny.At times not totally sensible. The story line did have a uniqueness only John Irving could bring to paper. I did enjoy the first half of the novel more, simply because there was more going on. Wallington's trip to japan--for the 'Future of Women' conference--was hilarious, as were some of his other rendezvous'. The subplot involving Dr. Zajac and his problems drew me in too. The character of Doris Clausen seemed rather shallow and I found it hard to believe that Wallington could even fall in love with this lady. The book did lack emotion and depth with some of the characters, but the plot and comical farce made up for some of that. An overall fun and quick read for the summer.

Recommended.