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.
ABCS Surgical Anatomy for Cosmetic Procedures 1
Which facial nerve branch is most at risk during a rhytidectomy (facelift) when dissecting near the zygomatic arch?