ABCS Surgical Anatomy for Cosmetic Procedures 1 — Questions and Answers
Question 1: Which facial nerve branch is most at risk during a rhytidectomy (facelift) when dissecting near the zygomatic arch?
- Buccal branch
- Temporal branch (Correct answer)
- Marginal mandibular branch
- Cervical branch
Correct answer: Temporal branch
The temporal branch of the facial nerve crosses the zygomatic arch superficially and is highly vulnerable during facelift dissection in that region.
Question 2: The retaining ligaments of the face that are true osteocutaneous ligaments include which of the following?
- Platysma-auricular ligament
- Zygomatic and mandibular ligaments (Correct answer)
- Masseteric cutaneous ligaments
- Cervical retaining ligaments
Correct answer: Zygomatic and mandibular ligaments
The zygomatic and mandibular ligaments are true osteocutaneous ligaments that attach directly from periosteum to skin, while others are musculocutaneous in nature.
Question 3: In breast augmentation, the dual-plane pocket technique places the upper portion of the implant beneath which tissue layer?
- Breast parenchyma only
- Pectoralis major muscle (Correct answer)
- Superficial fascia
- Serratus anterior muscle
Correct answer: Pectoralis major muscle
In dual-plane augmentation, the upper implant lies under the pectoralis major while the lower portion is in the subglandular space, optimizing coverage and shape.
Question 4: The sentinel node in abdominoplasty refers to a perforator vessel that, if injured, may lead to flap necrosis. It typically arises from which source vessel?
- Superficial epigastric artery
- Deep inferior epigastric artery (Correct answer)
- Superficial circumflex iliac artery
- Internal mammary artery
Correct answer: Deep inferior epigastric artery
The sentinel or 'danger' perforator in abdominoplasty arises from the deep inferior epigastric artery and is critical to the vascular supply of the abdominal flap.
Question 5: Which anatomical layer is dissected during a sub-SMAS facelift to achieve greater vector control and longer-lasting results?
- Subcutaneous fat only
- Superficial musculoaponeurotic system (Correct answer)
- Deep cervical fascia
- Platysma muscle only
Correct answer: Superficial musculoaponeurotic system
The SMAS (superficial musculoaponeurotic system) is elevated and repositioned in a sub-SMAS facelift, allowing more durable repositioning of the midface and lower face.
Question 6: During upper blepharoplasty, damage to which structure can result in ptosis of the upper eyelid?
- Müller's muscle only
- Levator aponeurosis (Correct answer)
- Orbicularis oculi muscle
- Orbital septum
Correct answer: Levator aponeurosis
Inadvertent injury to the levator aponeurosis during upper blepharoplasty is the most common cause of post-operative eyelid ptosis.
Question 7: The safe zone for liposuction of the lateral thigh (lateral femoral cutaneous region) requires awareness of which nerve to prevent persistent numbness?
- Femoral nerve
- Sciatic nerve
- Lateral femoral cutaneous nerve (Correct answer)
- Obturator nerve
Correct answer: Lateral femoral cutaneous nerve
The lateral femoral cutaneous nerve runs in the subcutaneous layer of the lateral thigh, and aggressive liposuction in this zone can cause meralgia paresthetica.
