ABCS Breast and Body Contouring Surgery 3 — Questions and Answers
Question 1: A patient who had a previous Roux-en-Y gastric bypass requests body contouring after losing 120 lbs. Which nutritional deficiency most commonly impairs wound healing in this population?
- Vitamin A deficiency
- Iron deficiency
- Protein and zinc deficiency (Correct answer)
- Calcium deficiency
Correct answer: Protein and zinc deficiency
Massive weight loss patients after gastric bypass frequently develop protein and zinc deficiencies, both of which critically impair wound healing and collagen synthesis.
Question 2: During breast augmentation, a surgeon uses the inframammary fold incision and develops a pocket in the subglandular plane. Which complication is more common with subglandular versus submuscular placement?
- Hematoma
- Animation deformity
- Capsular contracture (Correct answer)
- Implant malposition laterally
Correct answer: Capsular contracture
Subglandular implant placement has a higher rate of capsular contracture compared to submuscular placement, likely due to reduced tissue coverage and bacterial contamination.
Question 3: A lower body lift is planned for a massive weight loss patient. The incision is placed to excise the circumferential excess. Which structure must be preserved to prevent lymphedema of the lower extremity?
- Femoral vein perforators
- Superficial inguinal lymph nodes (Correct answer)
- Great saphenous vein
- Lateral femoral cutaneous nerve
Correct answer: Superficial inguinal lymph nodes
The superficial inguinal lymph nodes lie near the lower body lift incision, and their disruption can cause significant lower extremity lymphedema.
Question 4: Which classification system is used to categorize breast ptosis in preoperative mastopexy planning?
- Regnault classification (Correct answer)
- Baker classification
- Simon classification
- Rohrich classification
Correct answer: Regnault classification
The Regnault classification defines breast ptosis grades based on the nipple position relative to the inframammary fold.
Question 5: A patient undergoes power-assisted liposuction (PAL) of the outer thighs. Which advantage does PAL offer over traditional liposuction in fibrous areas?
- Reduced need for tumescent infiltration
- Mechanical oscillation reduces surgeon fatigue and improves fat disruption in fibrous tissue (Correct answer)
- Eliminates the need for general anesthesia
- Lower risk of contour irregularities
Correct answer: Mechanical oscillation reduces surgeon fatigue and improves fat disruption in fibrous tissue
PAL uses mechanical oscillation of the cannula to break up fibrous fatty tissue more efficiently while reducing surgeon fatigue compared to manual technique.
Question 6: A 45-year-old woman desires a buttock augmentation with fat transfer (Brazilian Butt Lift). Preoperative planning should include assessment of which donor site characteristic?
- BMI greater than 35 to ensure adequate donor fat
- Sufficient donor fat volume in appropriate harvest sites (Correct answer)
- Absence of cellulite in the harvest area
- Prior liposuction in the harvest area
Correct answer: Sufficient donor fat volume in appropriate harvest sites
Adequate donor fat volume in accessible sites (abdomen, flanks, thighs) is the primary determinant of whether sufficient fat can be harvested and transferred for BBL.
Question 7: Regarding fat grafting survival, which layer of the buttock is the SAFEST and most appropriate for fat injection to minimize risk of fat embolism?
- Deep intramuscular gluteal injection
- Subcutaneous plane superficial to the gluteal fascia (Correct answer)
- Subfascial but superficial to the muscle belly
- Subperiosteal over the ileum
Correct answer: Subcutaneous plane superficial to the gluteal fascia
Fat should be injected into the subcutaneous plane superficial to the gluteal fascia to avoid inadvertent intramuscular injection near the gluteal venous sinusoids, which carries lethal fat embolism risk.
ABCS Breast and Body Contouring Surgery 3
A patient who had a previous Roux-en-Y gastric bypass requests body contouring after losing 120 lbs.
Which nutritional deficiency most commonly impairs wound healing in this population?