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1580 MCQ's

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A. Riera March, MD

1571-1580 MCQ in Facial Plastic and Reconstructive Surgery

 1571-1580

------------------------------
Updated: Dec 10, 2024

1571) Which of the following Free Flaps is considered the workhorse for mandibular reconstruction in the pediatric population?

A. Iliac crest free flap
B. Radial free flap

C. Fibula free flap

D. Scapula free flap (scapular tip)
E. Scapula free flap (lateral scapular border)

1572) Which of the following surgical steps in the management of thick skin rhinoplasty is FALSE?

A. Open approach

B. Supraperichondral tip dissection

C. Avoid selective defatting

D. Lateral crural tensioning

E. Septal extension graft

1573) Which of the following surgical technique is NOT USED in the Cleft Palate Repair?

A) Unipedicled two-flap palatoplasty (Bardach and Salyer).

B) Bipedicled flap palatoplasty (Von Langenbeck)

C) Mohler technique Palatoplasty (Millard Technique modification)

D) V-Y Advancement (Veau-Wardill-Kinner) palatoplasty.
E.) Furlow Palatoplasty (Double Opposing Z-Plasty)

1574) Which of the following statements in pediatric vascular tumor is FALSE?? 

A. Infantile hemangioma is the most common tumor of infancy.
B. Minimally or not detectable at birth.

C. Rapid growth in the first year of life
D. Do not regress or involute
E. Propanolol therapy has demonstrated great efficacy in their treatment.

1575) After the administration of botulinum toxin injection at the glabellar region the patient develops an upper eyelid ptosis. Which of the following medication is the one used to treat this complication? 

A. Artificial tears

B. Lidocaine ophtalmic

C. Apraclonidine eye drops
D. Dexametasone eye drops

E. Gentamicin ophthalmic

1576) Which of the following surface anatomy nomenclature is the ONE marked by the arrow?

A. Trichion

B. Nasion 
C. Rhinion

D. Supratip 

E. Pogonium

.
1577) Which of the following is the MOST common complication seen in the use of the Temporal Parietal Fascia Flap (TPFF)?

 

A. Alopecia
B. Necrosis

C. Weakness of the frontalis muscle

D. Venous congestion
E. Hematoma

1578) Which of the following components is NOT considered related to the "Preservation Rhinoplasty"?

A. Elevation of the soft tissue envelope in the sub-SMAS plane.

B. Presertion of the scroll ligament complex.

C. Presertion the nasal dorsum without creating an open roof deformity.

D. Maintaining the alar cartilage, avoiding lateral crural resection.

E. Dorsal preservation (with en bloc dorsal lowering).

1579) Which of the following statements regarding the Anterior Septal Angle in the open dorsal approach to rhinoplasty is FALSE?

A. It is the most anterior projecting point  of the septum.

B. It contributes to the nasal tip support

C. It contributes to the tip projection
D. It contributes to the nasal length

E. It contributes to the external nasal valve function

1580) Which of the following statements regarding Botulinum toxin to treat facial wrinkles is FALSE?

A. It is a protein produced by the anaerobic gram-positive bacteria

B. Botulinum type A and Type B are only used clinically.

C. Botulinum toxin is injected into the intradermal plane

D. Complete paralysis of the muscle occurred 5-7 days

E. Clinical results can last up to 3-4 months.

ANSWERS & REFERENCES


1571) A    Fibula free flap

Wang W., Shokri T., Ruiz-Mojica C., Ducic Y.: Pediatric Free Flaps: Indications, Considerations, and Follow up, Facial Plastic Surgery Clinic N. America, 33 (2025), pp. 109-115

1572) C     Avoid selective defatting

Cobo R., Patrocinio L.G., Guyuron B., Swanson M.: Management of thick skin in Rhinoplasty, Facial Plastic Surgery Clinic N. America, 32 (2024), pp.473-493

1573) C    Mohler technique Palatoplasty (Millard Technique modification)

Long B. D., Petersson R.S.: Primary Cleft Palate Repair, Facial Plastic Surgery Clinic N. America, 32 (2024), pp. 55-62

1574) C    Do not regress or involute

 

  Urbamn, M., Williams E. F.: Vascular Lesions, Facial Plastic Surgery Clinic N. America, 32 (2024), pp.13-25

1575) C   Apraclonidine eye drops

Gillman G. S.: Cosmetic Uses of Neurotoxins and Injectable Fillers, chapter 197 in Bailey's Head & Neck Surgery Otolaryngology (Johnson and Rosen, editors), Fifth Edition, 2014, Walters Kluwer/Lippincott Williams & Wilkins, pp. 3239-3251

1576) C    Rhinion

Gillman G.S.: Rhinoplasty: Incisions, Approaches and Analysis, Chapter 180, Bailey's Head & Neck Surgery Otolaryngology (Johnson and Rosen, editors), Fifth Edition, 2014, Walters Kluwer/Lippincott Williams & Wilkins, pp. 2941-2951

1567) A    Alopecia

https://www.ncbi.nlm.nih.gov/books/NBK482275/

https://www.ncbi.nlm.nih.gov/books/NBK555905/

1578) A     

  

Patel P. N., Most S. P.: Overview of Dorsal Preservation Rhinoplasty, Facial Plastic Surgery Clinic N. America, 31 (2023), pp. 1-11

1579) E     It contributes to the external nasal valve function

Rod J Rohrich, Phillip B Dauwe,  Benson J Pulikkottil , Ronnie A Pezeshk: The Importance of the Anterior Septal Angle in the Open Dorsal Approach to RhinoplastyPlast Reconstr Surg. 2017 Mar;139(3):604-612

1580) C     Botulinum toxin is injected into the intradermal plane

Kontis T. C.: Injectables for Rejuvenation, Chapter 21 in Facial Plastic and Reconstructive Surgery (Desai S.C. , editor), Plural Publishing, Inc., 2017, pp.197-206

-------------------------------

Updated: Dec. 10, 2024

1561-1570 MCQ in Facial Plastic and Reconstructive Surgery

  1561-1570

------------------------------
Updated: July 2, 2023 

1561) Which of the following statements regarding the SUBDOMAL graft in rhinoplasty is FALSE?

A. It is a bar-shaped graft placed in a pocket under the domes.
B. It is indicated for correction of dome asymmetry.

C. It is indicated for improving tip projection.

D. It is indicated for correction of a pinched nose tip deformity.
E. The nasal septal cartilage is the preferred grafting material

1562) Which of the following modalities of non-surgical treatment for male pattern hair loss is approved by the Food and Drug Administration?

A. Carbon Dioxide laser 

B. Erbium:YAG laser

C. Low-level laser light therapy

D. Platelet-Rich Plasma injections 

E. Spirolactone topical use

1563) Which of the following is the critical component in the successful open rhinoplasty?

A) Cottle incision to nasal septum

B) Killian incision to nasal septum

C) Anterior septal angle  approach

D) Full transfixion incision
E.) Hemi transfixion incision

1564) Which of the following complications is the most common seen in Dorsal Preservation Rhinoplasty (DPR)? 

A. Persistence of the dorsal hump.
B. Polly beak deformity.

C. Open roof deformity.
D. Nasal valve stenosis.
E. External nasal valve collapse.

1565) Which of the following in Dorsal Preservation Rhinoplasty (DPR) is FALSE? 

A. DPR avoids lateral crural resection.

B. DPR uses a subperichondrial dissection plane.

C. DPR utilizes a  bloc lowering of the nasal dorsum
D. DPR is best if used in V-shaped nasal bone

E. DPR requires the use of spreader grafts.

1556) Which of the following area is considered the "keystone area" in rhinoplasty analysis"

A. A

B. B
C. C

D. D

E. E

.
1567) Which of the following is the MOST common complication seen in the use of the Temporal Parietal Fascia Flap (TPFF)?

 

A. Alopecia
B. Necrosis

C. Weakness of the frontalis muscle

D. Venous congestion
E. Hematoma

1568) Which is the proper timing to initiate radiation therapy following ontological surgery without significantly impending wound healing?

A. 2 weeks

B. 3 weeks

C. 6 weeks

D.  8 weeks

E. 10 weeks

1569) Which of the following is NOT considered a long-term complication/cell damage after the course of radiotherapy?

A. Necrosis

B. Atrophy

C. Hyperglycemia
D. Fibrosis

E. Carcinogenesis

1570) Which of the following statements regarding preventative measures against rhinoplasty complications is FALSE?

A. Septal hematoma/Quilting sutures

B. Bossae/Maintain at least 4 mm of lower lateral cartilage  during cephalic trimming.
C. Rocker deformity/Avoid osteotomies to far into the frontal bones.

D. Inverted V deformity/autospreader graft placement.

E) Pollybeak deformity/adequate take-down of cartilaginous dorsal septum with removal of the anterior septal angle.

ANSWERS & REFERENCES


1561) C    It is indicated for improving tip projection.

Karimnejad K., Walen S.: Functional and Cosmetic Eyelid Surgery, Complications in Eyelid Surgery, Facial Plastic Surgery Clinic N. America, 24 , May 2016, pp. 193-203

1562) C     Low-level laser light therapy

Tai Tymon, Kochhar A.: Physiology and Medical Treatment for Alopecia, Techniques for Hair Restoration, Facial Plastic Surgery Clinic N. America, 28 (2020), pp. 149-159

Justicz N., Derakhshan A., Chen J. X., Lee L. N.: Platelet-Rich Plasma for Hair Restoration, Techniques for Hair Restoration, Facial Plastic Surgery Clinic N. America, 28 (2020), pp. 181-187

 

1563) C     Anterior septal angle  approach

Rohrich R.J., Dauwe P. B., Pulikkottil B.J., Pezeshk R.A.: The Importance of the Anterior Septal Angle in the Open Dorsal Approach to Rhinoplasty, Special Topic,  Plastic and Reconstructive Surgery. 2017; 139 (3): 604-612

1564) A    Persistence of the dorsal hump.

 

Saman M., Saban Y.: Long-Term Follow-up with Dorsal Preservation Rhinoplasty, Facial Plastic Surg. Clin. North America 31 (2023) pp.13-24

1565) E.   DPR requires the use of spreader grafts.

Patel P. N., Most S. P., Saban Y.: Overview of Dorsal Preservation Rhinoplasty, Facial Plastic Surg. Clin. North America 31 (2023) pp.1-11

1556) A    A

Saman M., Saban Y.: Long-Term Follow-up with Dorsal Preservation Rhinoplasty, Facial Plastic Surg. Clin. North America 31 (2023) pp.13-24

1567) A    Alopecia

https://www.ncbi.nlm.nih.gov/books/NBK482275/

https://www.ncbi.nlm.nih.gov/books/NBK555905/

Revenaugh P.C., Shipchandler T. Z., Burkey B.B.: Microvascular and Regional Flaps in Head and Neck Reconstruction, chapter 51 in (Papel I. editor),  Thieme, Fourth Edition, 2016, pp. 650-677

1568) B      3 weeks

  

Hom D. B., Davis M. E.: Reducing Risks for Poor Surgical Wound Healing in  Facial Plastic Surgery Clinic N. America, 31 (2023), pp. 171-181

1569) C      Hyperglycemia

Hom D. B., Davis M. E.: Reducing Risks for Poor Surgical Wound Healing in  Facial Plastic Surgery Clinic N. America, 31 (2023), pp. 171-181

1570) B     Bossae/Maintain at least 4 mm of lower lateral cartilage  during cephalic trimming.

Watson D., Crawford K. L.: Reducing Surgical Risks in the Rhinoplasty Patient, Clinic N. America, 31 (2023), pp. 209-220

-------------------------------

Updated: July 2, 2023

1551-1560 MCQ in Facial Plastic and Reconstructive Surgery

 1551-1560

------------------------------
Updated: October 12, 2022 

1551) A "negative vector of the eye" noted in the lateral view of patient prior to blepharoplasty/eyelid surgery is related to

A. The upper eyelid
B. The lower eyelid

C. The lateral canthus

D. The medial canthus
E.  The brow

1552) Which of the following work up is the BEST recommended option for a patient with a self inflicted neck penetrating wound with a knife in Zone I? The patient is stable hemodynamically, without expanding hematoma or active bleeding?.

A. CT angiography

B. MRI angiography

C. Catheter conventional angiograpy

D. Ultrasound 

E. Surgical exploration

1553) The most common open approach used in the repair of Frontal Sinus Fractures is

A. Laceration present in the forehead

B. Horizontal midforehead furrow
C. Gullwing approach in the suprabrow position

D. Gullwing approach in the subbraw position
E. Coronal approach

1554) Which of the following regional flaps is the best for reconstruction of a large posterior neck and scalp oval shape defect size 12 cm x 9 cm?

A. Pectoral Major Musculocutaneous flap
B. Trapezius Musculocutaneous flap

C. Sternocleidomastoid Musculocutaneous flap
D. Plastysma Musculocutaneous flap
E. Temporalis Muscle flap

1555) Which of the following statements regarding the FRICKE Flap is false?

A. It is a cutaneous laterally-based mono-pedicle transposition flap from the supraorbital area.

B. It is ideal for reconstruction of upper and lower eyelid defects (anterior lamella)

C. It is necessary to keep 1:4 ratio the base to length dimension.
D. It is mandatory the dissection just below the underlying muscles of the brow.

E. It is recommended do not exceed and angle of 90 degree rotation of the flap.

1556) Which of the following rhinoplasty deformities will MOST LIKELY BE corrected by applying the surgical technique represented in the drawing below?  Please note that an spreader graft is used in each side of the nasal septum as well as a columellar strut that interdigitates with the spreader grafts.

A. Saddle nose

B. Crooked nose
C. Short nose

D. Overprojected nose tip

E.  Pollybeak nasal deformity

.
1557) Which of statements regarding M-plasty technique is FALSE?

 

A. It is an excisional technique used to remove dog ears cutaneous deformities.
B. It is also used for shortening the final wound length to conserve normal tissue.

C. It is placed on the end of an incision to avoid crossing an aesthetic facial subunit.
D. It is useful for closing facial wounds under tension.
E. "M" figure design  should have 30 degrees angles.

1558) Which of statements related to the "Tongue-in-Groove Technique in Septorhinoplasty is FALSE?

A. It is used in correcting a hanging columella/excess of columellar show.

B. The caudal septum is placed into the groove between the medial crura

C. It is useful for control nasal tip rotation, adjust tip position and correct caudal septal deviation.

D. It is not a conservative technique, involving resection of cartilage, therefore decreasing  the support of the nasal tip.

E. It can be used in primary and revision rhinoplasty cases.

1559) Which of the following indications is the LEAST adequate to apply the spreader flaps in rhinoplasty?

A. Unoperated nose, primary rhinoplasty.

B. Previous dorsal hump resection/secondary rhinoplasty.

C. Prominent dorsal hump.
D. Tension nose deformity

E. Mild crooked nose

1560) Which of the following statements regarding the Lower Trapezius flap is FALSE?

A. It is the most versatile of the trapezious flaps.

B. It is ideal for large defects in the posterior neck and posterior scalp
C. It is supply by the Transverse Cervical Artery (TCA) and the dorsal scapular artery (DSA)

D. It is mandatory the preservation of both arteries  - TCA and DSA - for flap survival.

E) It is usually close the donor site performing wide undermining of the margins.

ANSWERS & REFERENCES


1551) B     The lower eyelid

Karimnejad K., Walen S.: Functional and Cosmetic Eyelid Surgery, Complications in Eyelid Surgery, Facial Plastic Surgery Clinic N. America, 24 , May 2016, pp. 193-203

1552) A     CT angiography

Saito N., Hito R., Burke PA., Sakai O.: Imaging of penetrating injuries of head and neck current practice at a level I trauma center in the United States. Keio J Med 2014 63 (2): 22-33

Stewart M. G.: Penetrating Face and Neck Trauma, chapter 76 in Bailey's Head & Neck Surgery Otolaryngology, Volume One, Fifth Edition, (Johnson and Rosen, editors), 2014, pp. 1131-1140

 

1553) E     Coronal approach

Rodman R., Kellman R. M.: Chapter 36 Frontal Sinus Fractures, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 357-362

1554) B    Trapezius Musculocutaneous flap

 

Day A. T., Chaudhary H., Richmon J. D.: Chapter 40, Regional Flaps, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 403-414

1555) D.   It is mandatory the dissection just below the underlying muscles of the brow.

 https://journals.sagepub.com/doi/full/10.1177/2513826X19879454

1556) C    Short nose 

Katira Kristopher, Guyuron B.: Contemporary Techniques for Effective Nasal Lengthening, Rhinoplasty: Contemporary Innovations, Facial Plastic Surgery Clinic N. America, 23 (2015), pp. 81-91

1557) D     It is useful for closing facial wounds under tension.

https://www.ncbi.nlm.nih.gov/books/NBK482275/

1558) D      It is not a conservative technique, involving resection of cartilage, therefore decreasing  the support of the nasal tip.

  

Russell W. H. Kridel, Bruce A. Scott, and Hossam M. T. Foda: The Tongue-in-Groove Technique in Septorhinoplasty, A 10-Year Experience, Archives of Facial Plastic Surgery,Vol. 1, No. 4, Published online: Oct 1, 1999

1459) B        Previous dorsal hump resection/secondary rhinoplasty.

Kovacevic M., Wurm J.: Spreader Flaps for Middle Vault Contour and Stabilization, Rhinoplasty: Contemporary Innovations, Facial Plastic Surgery Clinic N. America, 23 (2015), pp. 1-9

1560) D    It is mandatory the preservation of both arteries  - TCA and DSA - for flap survival.

Day A. T., Chaudhary H., Richmon J. D.: Chapter 40, Regional Flaps, in Facial Plastic and Reconstructive Surgery, Clinical Reference  Guide, (Desai S.C, editor), Plural Publishing, 2017, pp. 403-414

Annino Jr D.J., Shu R.S., Gold D.R.: Chapter 56 in Musculocutaneous Flaps in Facial Plastic and Reconstructive Surgery, (Papel I. editor),  Thieme, Third Edition, 2009, pp. 757-764

-------------------------------

Updated: October 12, 2022 

1541-1550 MCQ in Facial Plastic and Reconstructive Surgery

 1541-1550

------------------------------
Updated: September 26, 2022 

1541) Which of the following statements regarding the management of a non-comminuted mandibular Angle Fracture is TRUE?

A. Conservative management with soft diet.
B. Conservative management with soft diet and maxillomandibular fixation.

C. Transosseous wiring with maxillomandibular fixation.

D. Monocortical plate placed along a Champy's line
E. Compressive dynamic plating on the lateral side of the body of the mandibule.

1542) Which of the following statements is a CONTRAINDICATION for the use of a single noncompression plate at the superior border of a Champy line in the angle of a mandibular fracture?

A. Comminuted fracture
B. Tooth in the fracture line
C. Unfavorable fracture

D. Asociated with a secondary fracture at parasymphisis/symphisis

E. The presence of impacted third molar           

1543) In the combined skin-muscle upper eyelid blepharoplasty the recommended MAXIMAL resection of muscle to avoid complicatios is DO NOT EXCEED 

A.   9 mm

B. 10 mm
C. 11 mm

D. 12 mm
E. 13 mm

1544) Which of the following rhinoplastic techniques will decrease tip projection?

A. Columellar strut
B. Cephalic trim

C. Transdomal suture
D. Interdomal suture
E.  Medial crural suture

1545) Which of the following statements used in the reconstruction of cutaneous defects involving the nasal tip is NOT recommended?

A. Split-Thickness Skin Graft (STSG)

B. Full-Thickness Skin Graft FTSG)

C. Bilobe Flap
D. Interpolated Paramedian Forehead Flap
E. Adjacent Tissue Transfer (ATT)

1546) Which of the following value is the distance (X) in cm represented in the drawing  from the foramen (black arrow) to  the lacrimal crest?

Left orbit

A. 10 cm

B. 15 cm 
C. 20 cm

D. 25 cm 

E. 30 cm

.
1547) Which of statements related to the Hemangiomas is FALSE??

 

A. Absent or small at birth.
B. Usually develop after birth.

C. Are more common in female than male 
D. The growth pattern usually is proliferation, plateau and involution. 
E. Laser treatment is safe, effective and well established.

1548) Which of statements related to the Port Wine Stains is FALSE?

A. Present at birth.

B. Grow in proportion of the child's growth.

C. Slow growth throughout lifetime, without regression or ulceration.

D. All patients will require treatment.

E. 532-nm KTP laser is the standard laser care.

1549) Which of the following statements regarding the Island Rotation Flap for Nasal Reconstruction is FALSE?

A. The pedicle is based on the superior alar branch of the lateral nasal artery.

B. It is ideal for defects smaller than 2 cm in diameter.
C. The flap width is designed 50% greater than the defect diameter.

D. The plane of dissection is submuscular, supraperiosteal/perichondrial.

E. A high percent of patients will require a second procedure.

1550) Which of the following management is considered the "gold standard" for prevention and  treatment of hypertrophic scars and keloids?

A. Pressure/compression therapy.

B. Massage therapy.
C. Silicone sheets and gels.

D. Intralesional corticosteroid injection

E) Imiquimod 5% cream.

ANSWERS & REFERENCES


1541) D     Monocortical plate placed along a Champy's line.

Standford-Moore G., Murr A.H.: Mandibular Angle Fractures, in Modern Approaches to Facial and Athletic Injuries, Facial Plastic Surgery Clinic N. America, 30 (2022), pp. 109-116

1542) A     Comminuted fracture

Braasch D.C., Abubaker A. O.: Management of Mandibular Angle Fracture, Oral Maxillofacial Surgery Clinic North America 2013; 25 (4):591-600

1543) A     9 mm

Kiang L., Deptula P., Mazhar M., Murariy D., Don Parsa F.: Muscle-Sparing Blepharoplasty: A Prospective Left-Right Comparitive Study, Arch Plastic Surgery. 2014; 41 (5): 576-583

1544) B    Cephalic trim

 

Ghavami A., Janis J.E., Acikel C., Rohrich R.J.: Tip Shaping in Primary Rhinoplasty: An Algorithmic Approch, Plastic Reconstructive Surgery., 2008;122 (4): 1229-1241

1545) A.   Split-Thickness Skin Graft (STSG)

 Collar R. M., Ward P.D., Baker S. R.: Reconstructive Perspectives of Cutaneous Defects Involving 
the Nasal Tip, Arch. Facial Plastic Surg. 2011; 13 (2); 91-96

1546) D    25 cm 

Flynn J.: Approach to Orbital Fractures After Athletic Injuries, in Modern Approaches to Facial and Athletic Injuries, Facial Plastic Surgery Clinic N. America, 30 (2022), pp. 31-45

1547) E     Laser treatment is safe, effective and well established.

Stier M.F., Glick S. A., Hirsh R. J.: Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas, J. A. Acad. Dermatology 2008; 58: 261-285

1548) E      532-nm KTP laser is the standard laser care.

Stier M.F., Glick S. A., Hirsh R. J.: Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas, J. A. Acad. Dermatology 2008; 58: 261-285

1449) E     A high percent of patients will require a second procedure.

Siddiqui A., Ditmars Jr. D. M.: Island Rotation Flap for Nasal Reconstruction, Plastic Reconstructive Surgery, 2005; 116: 1604-1609

1550) C.     Silicone sheets and gels.

Monstrey S., Middelkoop E., Vranckx J.J., Bassetto F., Ziegler U. E., Meaume S.: Updated Scar Management Practical Guidelines: Non-invasive and invasive measures, Journal of Plastic, Reconstructive & Aesthetic Surgery (2014) 67, 1017-1025

-------------------------------

Updated: September 26, 2022 

1531-1540 MCQ in Facial Plastic and Reconstructive Surgery

 1531-1540

-------------------------------
Updated: September 16, 2022 

1531) Which of the following statements related to the DEEP plane dissection used to reconstruct cutaneous defects after Mohs surgery is TRUE?

A. It is an axial flap based on the superior temporal artery.
B. It is a composite flap based on the skin and SMAS elevated en bloc.

C. It is not indicated in smokers patients.
C. It is contraindicated with history of radiation therapy in the affected area.
D. It will not required to correct standing cutaneous deformities adjacent to the defect.

1532) Which of the following area of the face is MOST effectively improved with a Full-Incision Face Lift compared to a Short-Scar Face-Lift ?

A. Nasolabial fold
B. Jawline
C. Neck

D. Preauricular 

E. Postauricular

1533) Which of the following blepharoplasty eyelid terminology is FALSE?

A. Dermatochalasis: Excess skin of the eyelid

B. Negative vector: The anterior most point of the cornea projects beyond the inferior orbital rim.
C. Tear trough deformity:  Soft tissue depression seen along the medial inferior orbital rim

D. Malar mounds: Redundant folds of lax skin and orbicularis muscle.
E. Scleral show: White sclera show between the inferior limbus of the iris and the margin of the lower eyelid in the Frankfort horizontal plane

1534) Which of the following statements regarding the forehead flap is TRUE?

A. It is based in the supraorbital artery
B. The greater the pedicle width,.the greater is the arch of rotation

C. A folded paramedian flap can be used to reconstruct inner mucosal lining and external soft tissue simultaneously.
D. The pedicle is divided at 10 days
E.  The donor area will require a full-thickness skin graft for closure the defect

1535) Which of the following statements is indicated the USE  of antibiotics before surgery -  in facial fracture management?

A. Mandibular fractures (not isolated condyle)

B. Isolated mandibular condyle fractures
C. Midface fractures
D. Frontal Sinus fractures
E. Skull base fractures:

1536)Which of the following is the VALUE of the angle "X" represented in the local flap seen in the drawing below?

A. 30 degrees

B. 40 degrees
C. 50 degrees

D. 60 degrees

E. 70 degrees

.
1537) Which of the following facial characteristics is NOT IDEAL in the selection for a proper candidate for  Rhytidectomy?

A. Sharp cervico-mental angle
B. Strong facial bony structures

C. Round face
D. Fuller mid-face
E. Shallow melo-labial folds

1538) Which of statements in the diagnosis of the Zygoma/Tripod fracture is FALSE?

A. Enophtalmus.

B. Trismus

C. Protrusion/bulge of the malar bone

D. Subconjuntival hemorrhage

E. Hypesthesia/anesthesia of V2

1539) Which of the following statements regarding Hyaluronic Acid (HA) is FALSE?

A. Hyaluronic Acid (HA) does not require a skin test.

B. Hyaluronic Acid (HA) can be injected into the deep dermis, SQ or preperiosteal.
C. It can be used added with or without lidocaine. 

D. Hyaluronic Acid (HA) with a low G' (G prime) is firmer, thicker and tend to keep their shape after injection. 

E. Hyaluronidase (HAse) is used to dissolve HA if necessary.

1540) Which of the following statement is the MAIN ADVANTAGE of  the Deep-Plane vs Subcutaneous cervicofacial rotation-advacement flaps in facial cutaneous defects reconstruction?

A. Decrease seroma formation

B. Decrease hematoma formation
C. Decrease distal flap necrosis

D. Decrease facial nerve paralisis

E) Decrease sialocele formation

ANSWERS & REFERENCES


1531) B     It is a composite flap based on the skin and SMAS elevated en bloc.

Jacono A.A., Rousso J.J., Lavin T.J.: Comparing rates of distal edge necrosis in deep-plane vs subcutaneous cervicofacial rotation-advancement flaps for facial cutaneous Mohs defects, JAMA Facial Plastc Surgery, 2014; 16 (1)31-35

1532) C      Neck

Antell D. E., May J.M., Bonnano M.J., Lee N.Y.: A Comparison of the Full and Short-Scar Face-Lift Incision Techniques in Multiple Sets of Identical Twins, Plastic Reconstructive Surg. 2016; 137 (6): 1707-1714

1533) D    Malar mounds: Redundant folds of lax skin and orbicularis muscle.

Perkins S. W., Prischmann J.: Lower Eyelid Blepharoplasty,  Chapter 187 in Bailey's Head and Neck Surgery, (Johnson & Rosen, editors), Fifth Edition, 2014, pp. 3085-3102

Dzifa S. Kpodzo, MD, MPH, Foad Nahai, MD, Clinton D. McCord, MD: Malar Mounds and Festoons: Review of Current Management, Aesthetic Surgery Journal, Volume 34, Issue 2, February 2014, Pages 235–248

1534) C    A folded paramedian flap can be used to reconstruct inner mucosal lining and external soft tissue simultaneously.

 

Justicz N., Lee Li. N.: Primary and Local Flaps, chapter 39 in Facial Plastic and Reconstructive Surgery, Clinical Reference Guide, (Desai S. C., editor), Plural Publishing, 2017, pp. 387-402

1535) A  Mandibular fractures (not isolated condyle)

 Doerr T. D.: Evidence-based Facial Fracture Management, Facial Plastic Surgery Clinic North America, 2015; 23 (3):335-345

1536) C     60 degrees

Jewett B.: Local Cutaneous Flaps and Grafts, Chapter 173 in Bailey's Head and Neck Surgery, (Johnson & Rosen, editors), Fifth Edition, 2014, pp. 2797-2823

1537) C     Round face

Perkins S. W., Waters H.H.: Rhytidectomy, Chapter 14 , Facial Plastic and Reconstructive Surgery (Papel, I, editor), 2016, pp. 139-158

Sand J. P., Hahn S., Branham G.H.: Rhytidectomy, chapter 34 in Facial Plastic and Reconstructive Surgery, Clinical Reference Guide, (Desai S.RodmC., editor), Plural Publishing, 2017, pp. 163-174

1538) C      Protrusion/bulge of the malar bone

Rodman R., Kellman R. M.: Midface and Pan-Facial Fractures, chapter 34 in Facial Plastic and Reconstructive Surgery, Clinical Reference Guide, (Desai S. C., editor), Plural Publishing, 2017, pp. 339-345

1439) D     Hyaluronic Acid (HA) with a low G' (G prime) is firmer, thicker and tend to keep their shape after injection.

Kontis T.C.: Injectables for Rejuvenation, chapter 21 in Facial Plastic and Reconstructive Surgery, Clinical Reference Guide, (Desai S.C., editor), Plural Publishing, 2017, pp. 197-206

1540) C       Decrease distal flap necrosis

Jacono A.A., Rousso J.J., Lavin T.J.: Comparing rates of distal edge necrosis in deep-plane vs subcutaneous cervicofacial rotation-advancement flaps for facial cutaneous Mohs defects, JAMA Facial Plastc Surgery, 2014; 16 (1)31-35

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Updated: September 16, 2022