ASPS Cosmetic & Aesthetic Surgery 2 — Questions and Answers
Question 1: Which facial nerve branch is most at risk during a traditional facelift (rhytidectomy) procedure?
- Temporal branch
- Buccal branch
- Marginal mandibular branch (Correct answer)
- Zygomatic branch
Correct answer: Marginal mandibular branch
The marginal mandibular branch of the facial nerve is at highest risk during facelift surgery due to its superficial course near the mandible and limited redundancy.
Question 2: A patient requests lip augmentation with a natural appearance. Which filler is considered the gold standard for lip enhancement?
- Calcium hydroxylapatite (Radiesse)
- Poly-L-lactic acid (Sculptra)
- Hyaluronic acid (e.g., Juvederm) (Correct answer)
- Polymethylmethacrylate (Bellafill)
Correct answer: Hyaluronic acid (e.g., Juvederm)
Hyaluronic acid fillers are the gold standard for lip augmentation because they are reversible with hyaluronidase, provide natural results, and have an excellent safety profile.
Question 3: What is the primary goal of the SMAS (superficial musculoaponeurotic system) plication during a facelift?
- Reduce skin tension on the closure (Correct answer)
- Remove excess facial fat
- Tighten the platysma muscle
- Elevate the malar fat pad
Correct answer: Reduce skin tension on the closure
SMAS plication redistributes tension to the deeper tissue layer, reducing tension on the skin closure and minimizing the risk of visible scarring and distortion.
Question 4: Which injectable neurotoxin is FDA-approved for treatment of moderate-to-severe glabellar lines and is most commonly used in aesthetic practice?
- Abobotulinum toxin A (Dysport)
- Onabotulinumtoxin A (Botox) (Correct answer)
- Incobotulinum toxin A (Xeomin)
- Prabotulinumtoxin A (Jeuveau)
Correct answer: Onabotulinumtoxin A (Botox)
OnabotulinumtoxinA (Botox) was the first FDA-approved neurotoxin for cosmetic use and remains the most widely used for glabellar lines and other aesthetic indications.
Question 5: During upper blepharoplasty, which structure must be preserved to prevent ptosis?
- Orbicularis oculi muscle
- Levator aponeurosis (Correct answer)
- Whitnall's ligament
- Müller's muscle
Correct answer: Levator aponeurosis
Inadvertent injury to the levator aponeurosis during upper blepharoplasty can cause postoperative ptosis, making its identification and preservation critical.
Question 6: Which body contouring procedure uses controlled cooling to selectively destroy fat cells without surgery?
- Laser lipolysis (SculpSure)
- Radiofrequency (Thermage)
- Cryolipolysis (CoolSculpting) (Correct answer)
- High-intensity focused ultrasound (HIFU)
Correct answer: Cryolipolysis (CoolSculpting)
Cryolipolysis (CoolSculpting) uses precisely controlled cooling to trigger apoptosis of adipocytes without damaging surrounding tissue, reducing fat in targeted areas.
Question 7: A patient develops visible wrinkling and rippling of a saline breast implant. What is the most likely cause?
- Capsular contracture
- Implant malposition
- Inadequate soft tissue coverage (Correct answer)
- Hematoma formation
Correct answer: Inadequate soft tissue coverage
Visible rippling and wrinkling of saline implants is most commonly due to inadequate soft tissue coverage, particularly in thin patients or with subglandular placement.
ASPS Cosmetic & Aesthetic Surgery 2
Which facial nerve branch is most at risk during a traditional facelift (rhytidectomy) procedure?