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502 Cards in this Set

  • Front
  • Back
complication rate abdomenoplasty

smoker

non-smoker
smoker = 50%

non smoker = 25%
% rhytidectomy requiring

drain hematoma
3-5%
most common acquired ptosis
degeneration levator apponeurosis
buccal fat pad hernia (pseudo-hernia)

what fascia
buccopharyngeal fascia
NAC sensability
3rd, 4th, 5th intercostals

90% lateral branch crosses throug the pect. major

lateral branch T4
infiltrate/aspirate/blood loss

superwet

tumescent

wet
superwet 1:1 1-4% ebl

tumescent 2-3:1 1% ebl

wet 25% ebl
malar fat pad

arterial supply
angular artery
botox complication

blepharoptosis Rx?
alpha adrenergic gtts.
traumatic tatoo Rx?
Q switched laser
Retenoids
decrease activation of metalloproteases

by inhibit AP1 transcription
laser wave length with the greatest affinity for water
2940 nm

Erb:Yag
upper lid ptosis Rx

reposition lev appon >3mm
advance mueller muscle <3mm
Fasenella Servat
Levator resection
Frontal resection
good levtr func. = reposition

advan muell musc=<3 mm ptosis
eyebrow suspen.= poor lev func
Fas.Serv = lev >10mm,ptos <2mm
shortens lower components of the lid (tarsus,conjunctiva,mueller's)
lev resect = ptos >3mm,
lev func 4 - 10 mm
frontal suspn = poor lev func.
exception to complication secondary to smoking
no fat necrosis
Propecia inhibits ?
5 alpha reductase
cartilage graft

survival most related to ?
protoglyco matrix
endermologie
Rx cellulite

increases transverse collagen in the deep sq tissue
fat grafting

most common complication
retension

greatest resorption
mst com complx = under correction

retensoion = 40 - 78%

greates resorption = NLF
Jessener's solution
ETOH
Lactic acid
Resorcinal
Hyaluronic acid
Abdomenoplasty

nerves at risk

nerves not at risk
risk = iliohypograstic
ilioinguinal
intercostal

not at risk = genitofemoral
fat retension
50% 6 month

30% 9 month
cause of arm skin ptosis
clavopectoral fascia
most common complication of

tip graft for poor tip projection
visability of graft
dermal peel after rhytidectomy

delay?
3 months
width of nasal alar defect for composite graft
1.5 cm
cosmetic subsets of the nose

#
9
zyderm test
1 month
restylene
hyaluronic acid
decrease depth of phenol peel
liquid soap
primary blood supply to the facial skin after

rhytidectomy
transverse facial artery
delay secondary rhynoplasty
12 months
SMAS plication

not safe.........
distal to lateral border of

zygomatic major muscle
innervation of the upper ear
lesser occipital nerve
absence of auriculocephalic sulcus = ?

timing of surgery
cryptocia

delay surgery
otoplasty

revision rate
8 - 24%
prominent ear

apex protrusion
24mm
thigh lift

suture to .........
cole's fascia
purple/violet tatoo
Q switched Ruby laser
medpor
polyethelene

do not resterilize
cosmetic surgery

cutus laxa
erlers danlos
elastoderma
progeria
werner's syndrome
cutus laxa

(premature loss of elastic fibers)
burn scar hypertrophy if not healed by
3 weeks
kelod and hypertroghic scars are higher in .
ATP (adenosine triphosphatase)

fibroblasts
results of a chemical peel
dec. non lamellar collagen
inc. dermal thicness
inc fibroblast density
inc elatic tissue
alpha hydroxy acids

&

trentinoin
inc papillary collagen
inc blood vessels
inc glucosamine and glycans
exfoliates
thickens epidermis
lasers
co2
Erb:yag
alexendrite
pulse dye - copper vapor
Nd:Yag
co2- 10,600

erbyag - lymphatic - 3910

Nd-Yag - tatoo - 1064

alexendrite hair/blue green
tatoo 810

copper vap - small vessel 585
recurrence rate

excision hypertrophic scar
50 - 100%
Dapsone

most com. adverse effect
hemolysis
prominent NLF

results from loosening of ?
zygomatic ligaments
cosmetic dye pigments contain
iron (black pigment)
laser resurfacing and acutane
delay 2 years
fat retension at

9 months
30%
comlication of retrogenioplasty
anesthesia chin
most common nerve injury in

facelift
greater auricular
hair transplant
false growth 1 month

telogen phase 3 months
% breast = fat
50%
acutane =
isotrentoin
pathe of inspiratory air flow
through middle meatus
most ocmmon sequelae of

TCA peel
pigment change

usually hyper pignment which is transient
most important consideration in chin augmentation
occlusion
nerve injury risk in facelift

subsmas : non subsmas
4:1
TCA neutralized by
dermis
breast augmentation

%revision
%breast not seen on mammogram
%capsule contracture
%deflation
25% rev in 10 years

5% brst tiss. not seen on mam.

20-25% capsule contracture

1%?year deflation
BRAC-1

BRAC-2

risk of Ca
50-85%
implant rupture incidence
inc incidence 8-15 years

weak shell = most com cause
with severe atypia on biopsy

what is the incidence of DCIS in subcutaneous mastectomy
17%
implant rupture frequency
50% 7-10 years
presence of galactorrhea
measure prolactin

r/o pituitary tumor
capsule contracture is related to
fibrinogen
(surface bound protein)
ear amputation

artery
found on posterior surface

branches carotid, temporal, occipital
morpheaform BCC
Moh's
dusky 15 mm cartilage/skin composite graft to ear

RX
hyperbaric O2
transaxillary breast augmentation

risk
malposition
common canaliculus enters lacrimal sac
posterior to medial canthal tendon
face lift

most common facial nerve injures
buccal
saddle nose deformity
speader grafts support the septum
blepharoplasty

most common muscle injury
suprtion oblique
effect of corticocsteroids on post op edema and ecchymosis
none
jones test
I = dye flourescein reaches the beneath the inf turbisnate

II = dye in lacrimal sac
negative jones I, positive jnoes II
dacrocystorhynostomy
factor decreasing longevity of saline filled implants
underfilling
adverse effect of infracture of nasal bones
narrowing internal nasal valve
advantage of "extended" latissimus dorsi flap for breast reconstruction
added volume
mammograms >6 months post reduction mammoplast
calcifications
internal nasal valve
septum
nasal floor
caudal edge of upper lateral
cartilage
scleral show and lower lid blepharoplasty
lateral cnthopexy
breast reconstruction and post op radiotherapy
dealayed reconstruction with autologous tissue
planned botox injection of which muscle results in inadvertant ptosis
corregator (the target)

they want you to realize the risk of corregtor injection
ectropion post blepharoplasty

scar between
tarsal plate

and

capsulopapebral fascia
secondary rhytidectomy

risk vs. primary
destort hair line
evaluation of gynecomastia patient
examine genetalia
protect sensation to NAC
blunt dissection lateral to pectorlis muscle border
osseous genioplaste
corrects anterior-posterior

&

vertical deficiency
nasal tip projection
suture medial crura

tip grafting
NAC

nerves
3,4,5 interscostal nerves
(antereolateral branches)
lidocaine dose in tumescent liposection
as high as 55mg/kg
suction lipectomy ok in all except

axillary hyperhidrosis
hiv-assoc lipodystropohy
lymphedema
madelung's disease
liposarcoma
liposarcoma
inner ear abnormalities in

microtia
none

have middle ear abnormalities proportiate to the severity of the microtia
breast ca with post op radiation
delayed autologous tissue reconstruction
liposuction fluid management
infiltrate and iv fluids should = 2 x aspirate
most sensative area of breast
superior quadrants

(NOT nac)
15 y.o. with large breast mass
fibroadenoma
layer of scalp analagous to smas
galea
stahl's ear
3rd crus
ear reconstruction
remember prosthesis in absence of skin and temp fascia
implant breast reconstruction with necrotic skin
implant not exposed = resect skin and close

implant exposed = removal
numbness nasal tip
ext. branch anterion ethmoid
explanation for lack of tumnescent lidocaine toxicity
rate of absorption
complication abdomenoplasty and suction lipec.
avoid central area
rx facial nerve palsy 1 mo. post op facelift
observation
rx ectropion 6 months post blepharoplaty
lateral tarsal strip + skin graft
ear lobe

nerve
great auricular
levator palpebrae tendon
lies immediately superficial to Mueller's muscle
poland syndrome
requires absence of pectoralis muscles
asian vs occidental upper eyelid
preaponeurotic fat more caudal

levator muscle inserts closer to caudal border of tarsal plate
saline implant rupture

more likely with
under filling
(fold flaws)
transconjunctival blepharoplasty

structures incised
conjunctiva

capsulopapebral fascia
3 cm of skin slough post sub-smas rhytidectomy

Rx
observe
local wound care
sal

max dose of lidocaine
35 mg/kg
belt lipectomy

most com. smplx
seroma
stenstrom otobrasion

which surface
anterior anthelical fold
dorsal hump rasping with swelling and erythema 10 days post op
oral antbiotic
epiblepharon
a fold of skin that crosses the free margin of either the upper or lower eyelid so that the eyelashes are pressed against the globe
epiblepharon

Rx
resect redundant skin and orbicularis muscle

more common in asians
nasal septal fracture

physical finding
tear of mucosa
poland syndrome

assoc. anomalies
ipsilateral syndactyly or extremity hypoplasia

rib abnormalities
breast augmentaiton

reoperation rate in 10 yrs
25%
deep transverse glabellar lines

muscle
procerus
medial thigh lift

superficial dessection to avoid
lymphatic plexus
facial muscles innervated on superficial surface
buccal
mentalis
levator anguli oris
otoplasty
furnas
conchomastoid suture
otoplasty
mustarde
antihelical fold suture
otoplasty
stenstrom
carticlage scoring
(on surface opposite to direction of desired bending)
otoplasty
webster
suture tail helix to conchal bowl
otoplasty
lucket
skin resection

(also cartilage incision)
rhynoplasty

resection cephalad lower lat cartilage and resection caudal septum =
rotation tip (shortening nose)
neonatal molding of prominent ears

hormone responsible
estrogen

approx 6 weeks (longer in breast feeding babies)
raising eyebrow with botox

which muscle to target
orbicuolaris oculi
most important factor determining need for mastopexy after implant removal
preoperative ptosis
amputated ear cartilage banking

disadvantage
warping
percent of inferior pedicle breast reduction that are able to breast feed
approximately 60%

(brazillian study)
free margin ear resection 12 mm

best flap
antia buch
dusky composite graft to ear at two days

Rx
hyperbaric O2
advantage of endoscopic transaxillary augmentation vs. standard transaxillary
better implant position
(visualize medial pect, major and divide it)
lancinating pain in eye post blepharoplasty
retrobulbar hematoma

rexploration + steriod + acetazolamide
most commonly injured facial nerve in rhytidectomy
buccal
conjunctivorhynostomy
in patient with obliterated lacrimal sac
smoker risk with abdomenoplasty
50%
nasal infracture narrows what structure
internal nasal valve
advantage of "extended" lat. dorsi flap over standard lat dorsi flap
decrease need for implant
scleral show before bleparoplasy add what
lateral tarsorraphy
best landmark for positioning of nac in red. mamm markings
inframammary crease
methods for nasal tip projection
tip graft

suture medial crura
microtia

inner ear abnormalities?
none
location of hair follicles
subcutaneous
pierre robin mand deformity is ?
retrognathia
(not micrognatia bec in pierre robin the manible grows normally)
most likely effect of intralesional steriod for rx of keloid
relief of itching and burning
blepharophimosis syndrome
a form of congenital ptosis
epicanthal folds, horizontal shortening, severe ptosis
Blepharophimosis

Rx
correct epicanthal folds
correct ptosis
skin laxity arms post wgt loss= laxity of
clavopectoral fascia
blue-green tatoo

Rx
multiple treatments with

Q switched Nd:YAG
or alexendrite
red, brown, orange tatoo

Rx
Nd:YAG
violet-purplw tatoo
Rx
Q swithed ruby laser
upper cranial surface of the ear
nerve
lesser occipital
anterio surface upper ear
nerve
auriculotemoporal
dorasl nasal flap

size ?
position
2 cm
nasal tip
ptosis upper lid with > 10mm levator function

rx
levator advancement
"juvenile melanoma"

Rx
excision with clear margins only
excessive lower lateral cartilage resection with resultant airway obstruction

Rx
they want cartilage graft to increase tip projection
(prob won't work)
immediate post op ptosis
cause
Rx
swelling and hemorrhage into mueller muscle
Rx = observation
midline ant to occiput alopecia

Rx
saggital scalp reduction
nevoid basal syndrome (Gorlin's)
bcc + odontgenic cysts
(also palmar pits rib and spine abnormalities, intracranial calcifications)
Rs of suspected silicone implant rupture
surgery
symptomatic patient
incidence of breast implant rupture
31%
(goes up t0 80% with + ultrasound and 97% with + mri)
burn ear reconstruction
with skin scarring
cart framework with temp parietal flap and skin graft
retinoic acid (trentinoin) increases ?
typr III (embryonic) collagen
recurrent prom. ears
cause =
failure of Mustarde sutures(sutures to create the antehelical fold)
upper lid fat pads

location
superficial to levator palpabrae
posterior to orb. septum
actinic keratosis
5 f.u. cream (5% fluorocil)
effudex
highest position of brow in brow lift
they want from lateral limbus to lateral brow
(not on my patients)
nasal alar defect
nasolabial flap up to 1.75cm
nasal tip defect <1.2cm
banner flap
nasal dorsum defect >1.2 cm
bilobe flap
management of patient with massive wgt loss who will undergo additional20 lbs of wgt loss
they want surgery because "additional wgt loss will only make it worse"

duh - my answer is wait till the wgt loss is stable
another e.g. "can't argue with a piece of paper"
lateral traction on cheek relieving airway obstruction =
int nasal valve problem
vetrical nasal forehead lines

muscle
corregator
foreign body pigment

Rx
Q-switched ruby laser

2 - 3 treatments
epiphora

def.
excess tearing
medial thigh lift

suture to which layer
colle's fascia

(inelastic layer of the superficial perineal fascia)
microtia
usually requires excision of vestigial ear cartilage

True or False
True
breast implant most assoc. with visable wrinkling
textured saline
most common complication post otoplasty
recurrrence
numbness in medial arm post mastectomy

nerve?
intercostobrachial
prominent ear measurements
protrusion
scaphoconchal angle
cephaloauricular
protrusion = 24mm
scaphoconchal angle >90deg
cephaloauricular angle >25 deg
absent nac =
athelia
rapid growing umbilicated lesion =
keratoacanthoma

(key = rapid growth)
ear anesthetic include peripheral nerve block and
nerve of Arnold

(vagus in posterior wall of ext aud canal)
great auricular nerve

branch of
cervical plexus
most common complication of alloplastic malar implant
malposition
nerve at risk during resection of corregator muscle
supratrochlear
most important variable in the peak level of lidocaine in tumescent infiltration
absorption rate

related to epinephrine, tissure infused (vascularity), and rate of infiltration
long term effect of chemical peel in dermis
decrease of nonlamellar collagen
camera focal length for accuarate body images
55mm

face = 90 105mm
nonreplantible traumatic ear amputation

flap cover
post auricular
ectopic polymastia

most common site
chest

also, axilla, groin, vulva, medial thigh
otoplasty recreation of antelelical fold
permanent mattress sutures on posterior surface
(Mustarde)
male pattern baldness is triggered by
sex linked dominant gene

results in increase on 5alpha-reductase
TCA peel neutralized where
dermis
malar implants are placed on which muscle
masseter
male patient requesting aesthetic rhynoplasty
simon
single immature male overexpectant narcissistic

careful, do not operate
when exposing the zygomatic arch through a coronal incision, what layer should be incised
where
superficial layer of deep temporal fascia

level of lateral orbital rim
ratio of facial n. injury in subsmas facelift compared to subcutaneous facelift
4:1
nasal tip
nerve
external branch of
anterior ethmoid
trentinoin Rx

maximize effect with addition of
alpha hydroxy acids
"miniabdomenoplasty

indications
fullness and strtech marks limited to the infraumbilical area

test answer
subsmas dissection not safe
medial to the lateral border of zygomaticus major
facelift
men have more post op hematomas than woemen

true or false
true
bilateral florid adenosis with epithelial hyperplasia

indication for mastectomy
none

no additional risk for breast cancer
1% xylocaine = ? mg/ml
10mg/ml
10 g/l
most effective monitor of adequate fluid resuscitation
urine output
isograft

def.
a graft taken from the same individual or from a genetically identical genotype (identical twin)
bilobe flap is characterized as
transposition (interpolated) flap
most common cause of late silicone implant failure
weakening of silicone shell
kassabach-merritt syndrome
platelet consumptive coagulopathy with hemangiomas
what holds skin grafts in place within the first few days
fibrin bonding
rattle snake bite

venom suction value?
yes if done within 15 minutes

incisions no deeper than the skin
brachioplasty

fascia to anchor
axillary
breast shrinkage occurs with implants

T/F
true
larger implant more shrinkage
inferior oblique muscle function
extorsion,elevation, abuction
angle of divergence
between medial (middle) crura of lower lateral cartilage
wreatler's ear

Rx
evacuation of hematoma

tie through bolster dressing
vertical reduction mammoplasty advantage over inverted T
shorter scar
witch's chin deformity post genioplasty (increased lower tooth show)

cause
inadequate repair of mentalis muscle
wedge resection of lower lid for ectropion

contraindication
prominent globe

would "clothesline" the lid below the limbus
artery at risk in lateral osteotomy nose
angular
suspensory system for the globe
Lockwood's ligament
Poland syndrome

muscle most often missing
sternal head of pectoralis major
burn contracture inhibiting breast expansion

Rx
Integra (dermal regeneration template) said to allow secondary expansion
"washboard" irregularity post liposuction

most likely cause
superficial liposuction through a single port
incidence of occult breast cancer in reduction mammoplasty
0.2%
"side wall" nasal wrinkles caused by which muscle
nasalis
chondrodermatitis helicus

Rx
excision and primary closure
most common cause of death post liposuction
pulmonary embolus (fat or thrombus)
ratio of lobular portion of caucasion nose to columalla
1:2

(don't know what this means)
Rx of stahl's ear
resection of third crus and helical advancement
post mastectomy radiation

reconstruction technique
autologous tissue
orbital ligament

def;
clinical relavence
band of connective tissue fixing the superfial fascia to the bone of lateral orbital rim
must release during browlift
osteointegrated implants in burn ear reconstruction
high rate of complication

choose local flap reconstruction
vertical reduction mammoplasty

limitations
pedicle length (? 9 cm)

better with small (800gm) reductions
massive weight loss incision thigh
medial longitudinal
peak position of brow for brow lift
"between limbus and lateral canthus"

MOT ON MY PATIENTS
early infected ear cartilage reconstruction with fluctuance

Rx
i&d, irrigate, and place irrigation catheters
T3 invasive breast ca in large breast

reduction mammplasty?
yes, if tumor can be cleared as with lumpectomy standards
how long after alloplastic chin implant to wait if mental nerve paresthesia persists
2-3 weeks

(seems to short time to me)
reduction mammoplasty - nac sensation preservation most dependent upon
position of pedicle

(inferior is most protective)
what to do if infiltrating for liposuction and tachycardia occurs
stop infiltrating
cartilage ear reconstruction in the elderly

problem?
costochondral cartilage is ossified
nerve adjacent to external jugular vein
great auricular
grade 2 breast ptosis

Rx
mastopexy
implant is not enough
(probably some controversy)
most common complication of "lower body lift"
seroma
gynecomastia

medical Rx
Danazol, tamoxifen, testosterone
pubertal gynecomastia greater than 5 cm

regression %
none
gynecomastia

endocrine disorders causing
hrpogonadism
hyperthyroidism
adrenal disorders
serum prolactin level in patients with gynecomastia
normal
nac innervation
lateral branches of 4th intercostal
dominent blood supply to the breast
internal mammary perforators (60%)
indications for free nipple graft
>1500 gm reduction (?)
>25 cm nac transposition (?)
smoker (?)
diabetes (?)

(i use >19 cm vertical pedicle length)
how is breast cup size measured
breast girth exceeds chest girth by

1 inches = A
2 inches = B
3 inches = C
4 inches = D
reduction of 1 cup size

volume reduction
chest circumference - volume resection (to dec 1 cup size)

32-34 - 100 gm
36-38 - 200 gm
42-44 - 300 gm
44-46 - 400 gm
Rx of immediate post op cyanotic nac
remove nac sutures
re-explore if no improvement
what % of women can breast feed after pedicle reduction mammoplasty
60 - 70%
vertical scar reduction mammoplasty

maximum volume according to Lejour
1000 gms

(most suggest over 500 gms compromises the appearance)
most common planning error in reduction mammoplasties
placing th nac too high
contraindications to "doughnut" mastopexy
Grade 2 ptosis or greater

when implants are being downsized or removed at the same operation
definition

amazia
amastia
athelia
amazia - lack of glandular tissue
amastia - lack of breast
athelia - lack of nipple
what detemines the timing of polund syndrome breast reconstruction
development of contralateral breast
Tuberous breast
constricted height
hypoplasia
nac hypertrophy
definition

overweight
obese
overweight = BMI >25 <30
obese BMI >30
contraindications to autologous tissue breast reconstruction
morbid obesity
smoking
hypercoag disorder
general wellbeing (long surg)
unrealistic expectations
avg external diameter of DIEA
deep inferior epigastric artery average = 3.5 mm
what is PUP flap
diep flap based on a single peri-umbilical perforator
incidence of total flap loss in microvascular breast reconstruction
<5%
most common complication of tram flap at recipient site
fat necrosis
preferred method for lateral patial mastectomies
latissimus dorsi (?)

i agree but othes may not
blood supply to the umbilicus
diea, vessels from lig. teres and medial umbilical ligament
frequency of hernia post tram flap
2%
can abdomenal weakness occur after DIEP harvest
yes (?) may be controvesial
what is a Ruben's flap
dcia (deep circumfles iliac artery) flap
latissimus dorsi flap
type
art supply
type V

subscapular/thoracodorsal
how wide can the latissimus flap skin paddle be to allow primary closure of donor site
9 cm
will the serratus branch of the subscapular artery supply the latissimus flap with retrograde flow, if the thoracodorsal art. is divided
yes
are laproscopic scars a contraindication to abdomenal donor free flaps
no
ideal donor for the Ruben's flap
"gynecoid" (pear shaped) female of normal weight
TFL flap
art supply
innervation
lateral circumflex femoral (lateral branch)

motor = sup. gluteal
sensory = lateral fem. cutaneous/ branch T12
nerve at risk with dissection of IGAP flap
sciatic
anteriorlateral thigh flap
artery

location
lateral circumflex femoral

midpoint of a line between ASIS and patella
TAP flap
thoracodorsal perforator flap

perforatprs of the lateral branch of throacodorsal art.
TUG
transverse upper gracilis

used for breast reconstruction
what effect does smoking have on autologous ftt breast reconstruction
mastectomy flap and donor site healing

(no evidence that smoking effect microvascular patentcy)
how much should the breast pocket be overexpanded before implant reconstruction
20 - 30%
complications of nipple "sharing" in nipple reconstruction
scar deformity
loss of pigment
loss of donor nipple height
loss of donor sensation
when do mammary ridges develop in embryo
5 - 6 weeks gestation
what is the result of incomplete involution of the mammary ridge
accessory breast tissur and supernumery nipples
most common site of accessory breast tissue
axilla
where is the most common site of supernumery nopple
inframammary area
breast overlies which ribs
2nd - 6th
most common bacteria cultures from breast tissue
staph epidermidis
which internal mammary perforator is usually the largest
2nd
intercostal brachial nerve
supplies
branch
axilla and medial arm

2nd intercostal
course of the lateral branch of 4th intercostal
pierces the deep fascia in midaxillary line and courses deep to the pectoralis major fascia to midclavicular line the turns 90 degrees to the nac
normal diameter of nac
35 - 50mm
what ar montgomery glands
sebaceous glands in nac
breast parenchyma borders
lateral
superior
medial
lateral border of l.d.
clavicle
lateral stermum
what is major component of the anterior axillary fold
pectoralis major
where does the serratus anterior insert
deep surface of scapula
long thoracic nerve located in anterior or mid axillary line
midaxillary line
which nerves supply the medial breast skin
2nd - 6th medial intercostal branches
what is the blood supply to the abdomenoplasty flap
lateral intercostal vessels
nerves at risk for entrapment or injury in abdomenoplasty
iliohypograstic
ilioinguinal
intercostal
most tenuous blood supply in abdomenoplasty flap
infraumbilical midline
placement of incision for brachioplasty
medial from medial epicondyle to axilla
most common complication of brachioplasty
widened scar
composition of tumescent solution
1 L saline
50 cc 1% lidocaine
1 cc 1:1000 epinephrine
2.5cc 8.4% NaHCO3
blood loss in "superwet" technique
1%
most common complication of liposuction
contour irregularities
most important determinants for success of liposuction
skin/muscle tone and fat distribution
does ultrasound liposuction disrupt fibrous connective tissue
no
most common complication of abdomenoplasty
seroma
what is said to improve the long term results of body lift procedures
repair of superficial fascial system
belt lipectomy

long term complication (problem)
scar widening

flattening of buttocks
most common cause of death with liposuction
thromboembolism

rate = 1:5000
do fat cells removed by liposuction regenerate
no
levels of testosterone and estrogen in male pattern alopecia
normal
best donor site for hair transplantation
occipital
androgenic alopecia

what area
frontal

crown
what is the action of 5alpha reductase
convert testosterone to dihydryxytestosterone
is the hair bulb necessary to hair growth
no if the upper 2/3 of the follicle are intact a significant numble will grow hair
normal hair growth after transplant
1 cm/month
indication for scalp reduction
stable alopecia in
crown or vertex
main advantage of tissue expansion for Rx alopecia
hair follicle orientation is correct
50% of scalp can be covered
define thremal relaxation time
time for tissue to absorb and difuse heat through the tissue
define "pulse energy"
energy of one pulse
define power density
power/unit area

measured in watts/cm2
define fluence
total laser energy/unit area

joules/cm2
laser targets are called what
chromophobes
three chromophobes in the skin
hemoglobin
water
melanin
hair removal laser
ideal patient
dark hair/light skin
contraindication to hair removal laser
grey hair
accutane,retin A, tetracycline
dark skin (tan)
hx of herpes
how long to collagen fillers last
3 months
what is restylane
hyaluronic acid
(made from fermentation of sugar by eqine streptococcus)
how long do hyaluronic fillers last
6 months
what is Cymetra
injectable form of alloderm
Sculptra
poly-l-lactic acid

used for hiv assoc. facial lipodystrophy
botox

onset of action
6-36 hours

may take 7-14 days for max. effect
is pregnancy or lactation a contraindication for botox
yes
what is the difference between pulsed-dye, tunable-dye, and flash lamp-pumped pulsed dye lasers
no major difference, all used to Rx vascular anomalies
advantage of Q-switched laser
short pulse high energy laser targeting tatoo
Baker formula
phenol (3 ml)
croton oil (3 gtts)
liquid soap (8 gtts)
water (2 ml)
what is phenol
carbolic acid

derived from coal oil
Jessner's solution
resorciono 14g
salicylic acid 14g
laactic acid14ml
ethanol 100cc
how is depth controlled
baker (pheonol)
jessner
TCA
strength of sl'n (croton oil)
or contact time (taping)
numble of coats
strength of solution
first sign of phenol toxicity
cardiac arrythmias
normal dermal collagen ratio
I:III = 6:1
three primary components of dermis
glycoaminoglycns
collagen
elastin
most predominant tissue component of dermis
collagen 70 - 80%
which is the most "predictable" peeling agent
phenol (test answer- prob. controversial)
most common side effect of Retina A
erythema
classic agent for "medium depth" peel
35% TCA
what happens with lower concentrations of phenol
more penetration therefore more hazardess
can phenol be used anywhere else other than the ace
no
advantage of dermabrassion
less expensive
what structures comprise the nasal septum
cartilaginous plate, vomer, ethmoid, maxillary crest, palatine bone
nasalabial angle in men

" ' " " women
90degrees

100 degrees
what is consequence of lowering ot the nasal tip

what is the treatment
alar flarring

alar base resection
how much lower lateral cartilage should be left
5mm rim
what is Cottel sign
improved airway with lateral traction on the cheek
what is the cause of post rhynoplasty supra tip fullness
inadequate septal resection
botox

what is one unit
corresponds to the calculated median intraaperitoneal lethal dose (LD50) in mice
do men require higher dose of botox
yes, muscles are larger
how to avoid brow ptosis with botox injection
keep injection 1-2 cm above the brow
when to reasses patient post botox
2 weeks (is no effect or assymetry inject)
complications of platysmal band injection with botox
dysphagia, dysphonia, neck weakness
duration of action of botox
3 - 4 months
most common reported side effect
headache
FDA approved use
Rx of lines between the eyebrows of patients betwee 18 and 65 yeears
length of response of axillary hyperhidrosis
mean = 200 days
contraindicaitons to botox
sensativity to agent
infection at site
pregency
neuropathic disorders (amls,myasthenia etc)
analog of levator palpebrae in lower lid
capsulopalpebral fascia
most appropriate Rx of congenital ptosis upper lid
frontalis sling
most common injured muscle in blow out fracture
inf oblique
what will be the result of unilateral eyelid ptosis correction on the contalateral lid
it will become worse
how many fat compartments in

upper lid
lower lid
2

3
def: lagophthalmos
inability to close the eyelids
def: chemosis
edema of conjunctiva
flap used for total lower eyelid reconstruction
cheek rotation (mustarde)
most common cancer of eyelid
BCC
second most common eyelid cancer
SCC
third most common eyelid cancer
sebacwous cancer
def: arcus marginalis
periosteal thickening of the orbital rim where the orbital septum inserts
oil secreting glands of eyelid
meibomian and Zeiss
def; SOOF

ROOF
sub - orbicularis fat fat
retro- " " "
distance from orbital rim to apex
40-45mm
most appropriate temperature for operating room for extensive body contour surgery
70 degrees
best laser for capillaries
near 585 nm
(i.e.KTP)
factors that contribute to a communication between rt and lft augmentation cavities where the implant can be moved each way
multiple procedures
previous chest wall deformity
large base diameter
subpectoral positioning
factor that does not contribute to single rt and lft breast augmentation cavity
type of implant
what type of calcifications are most worrisome on mammography
branching or pleomorphic
what anatomic structure lies immediately deep to the levator palpebrae
muller's muscle
effect on pectoralis strength with submuscular implants
decrease
cardiac monitoring is necessary with which type of chemical peal
phenol
current recomended monitoring for reconstructed breast prosthesis
baselilne mri at 3 years and q 2 years after that
what is incised in a transconjunctival blepharoplasty
conjunctiva and capsulopalpebral fascia
presence of extra nipples on children should raise concern for ?
renal disease
what percentage of patients adenocarcinoma have polythelia
19%
ploythelia
def:
presence of supernumerary nipples
primary choice for pre op abiotic for rhynoplasty
cefazolin (ancef)

allergic = clindamycin
Rx of post operative "inverted v deformity" of nose
def: collapse of nasal sidewalls

Rx = spreader graft (? whether this is real- it is the book answer)
neg hx, no medication adolescent with gynecomastia
first step in evaluation
testicle exam and ultrasound
aging abdomen male vs female
diastasis
skin laxity
fat accumulation
diastasis men = upper women = lower
laxity = men less skin thicker
fat = men - central women - lateral and below iliac crest
Rx of Posative Cottle test

(nasal septum)
spreader graft
laboratory test suggesting increased risk for kleinfelter syndrome and risk of breast cancer
high number of progesterone receptors in mesenchymal breast tissue
vesicular rash post co2 laser

Dx
Rx
Herpes simplix

antiviral
the most likely cause of immediate blindness following fat injection into the tear trough
fat emolism
what is the route of fat embolism to the eye post fat injection in face
retrograde flow of fat into carotid system
what is the most effective ysstem to promote adherence of tissue to ear reconstruction cartilage schphold
closed suction

one author reported 33% incidence of necrosis with pressure dressing
what is the level of silicone in breast milk post augmentation
similar to women without implants
what is the most effective mechanism to prevent litigation with cosmetic patients
effective communication
what is the long term nasal deformity with untreated septal hematoma
saddle nose
`what is the normal growth pattern of micrografting of hair follivles
growth 1 month
hair loss (telogen phase)
hair growth begins 2 - 3 months
what is the most common unfavorable outcome of brachioplasty
unattractive scar
what is the biomechanical characteristic that is designed to minimize silicone "gel leak"
implant internal barrier coating
with dcis (ductal ca in situ)what is the risk of recurrent ipsilateral breast cancer post subcutaneous mastectomy (skin sparing)
2%
inervation of frontoparietal scalp
(risk of injury in brow lift)
supraorbital
innervation of supratrochlear nerve
nasal radix and central forehead
numbness in nac (nipple areolar complex) is injury to which nerve
4th intercostal
where should hyalouronic acid be injected to repair tear trough deformity
level of theperiostal
maximum recomended total volume of lipoaspirate
5000cc
ectopic polymastia

what is the most likely site
chest region including axilla

(90%)
what are the primary factors that should be considered in contralateral mastectomy in patient with dcis
in absence of BRACHA gene, previous biopsy concern, family hx, difficult mammogram interpretation,

most imp = patient choice
numbness in forearm post brachioplaty
injury =
medial antebrachial cutaneous nerve
what is the reported complication of a complete transfixation incision vs hemi transfixation incision for nasal septal Rx
decreased tip projection

(test answer - have done it all my life withour the problem)
what is the most sig. contributing factor to post op hematoma in face lilft
elevated blood pressure
ptosis upper lid post botox

cause
most common = levator paresis
second = paresis of frontalis in unrecognized senile ptosis
dry eye syndrome and upper blepharoplasty with lateral fullness
avoid injury/removal lacrimal gland
artery = predominant supply to the breast
internal thoracic (tnernal mammary)
contribution of arterial supply to the breast by thoracodorsal
none
superior and inferior gluteal arteries

branch of?
internal iliac
what anatomic structure neutralizes trichloracetic acid (TCA)
dermis
numbness of nasal tip = injury to which nerve
anterior ethmoid
anterior ethmoid nerve is anesthetized by topical anestiesia in what location
apex of the nasal bones at the caudal border.
relationship of metformin and gynecomastia
none
is a verbal agreement satisfactory for use of photographs in advertising
no
colles fascia is continuous with which structure
scarpa's
1.5 mm breslow melanoma Rx = resection and ?
sentinel ln bx
amazia - definition
absence of glandualr tissue only

NAC and chest muscle intact
athelia = def.
absence of nipple alone
poland syndrome
hypoplasia of absence of breast and pectoralis muscle
most likely cause of dissatisfaction post co2 lasar resurfacing
depigmentation

(occurs 100% of the itme 40% noticable)
breast pedicle least likely to preserve blood supply with mastopexy augmentation
inferior ( test answer ?fact or opinion?
with excess eyelid skin, what is the major disadvantage of the fasanella-servat procedure
no skin removal, performed theough conjunctival surace
medial inframmary flap

lateral inframmary flap

artery
medial internal mammary
lateral - intercostal perforators
excessive eyelid fat resection results in what lng term deformity
cadavaric apperance to eyes
open rhynoplasty and columella necrosis

cause
injury to branch of angular artery
(?) almost impossible
UAL needs
wet (to prevent nec to skin at entry site)
grade ii ptosis - mastopexy

grade iii ptosis - mastopexy
vertical

wise pattern
Rx cryptocia in which the superior part of the ear is buried
release helix and skin graft at age 5 or 6
best placement of skin paddle in autol breast recon
inferior/lateral
temporal branch facial nerve

plane of dissection to periosteum
most superficial
on undersurface of superficial temp fascia
no interconnecting branches
deep to superficial layer of deep temp fascia
amastia - def
absent breast and nipple
how far above the vulvar commisure is incision for mons elevation
5 cm
art supply to nasal tip
lateral nasal, branch of angular
poland syndrome
must have absence or hypoplasia of sternal head of pectoralis major muscle
wrestler's ear
hematoma within cartilage

Rx = drain + bolster dressing
thin subcutaneous cover and subglandualr saline implant
wrinkling
Rx of "nearly" amputated ear
suture
posative Cottle test

Rx
spreader graft
accessory mammary structures found
along milk line axilla to groin
ectopic mammary structures found
outside the mammary line
sharp deformity to anthelical fold post otoplasty
incising cartilage
infected implant post augmentaiton

Rx
remove implant
reinsert 6 mnths
buttock aumentation post massive wgt loss
autologous gluteal flaps
cosmetic forehead procedure for improvemet in bell's palsy
botox contralateral side
senile ectropion resulting in dry eyes is caused by
excess horizontal laxity of lower lid
best rx of burn ear
mafenimide (sulfamylon)
best escar penetration
Rx of adolesent with breast assmetry
adjustable implant (tissue expander)
chang size with normal side development
local anesthetic absorption rate above and below the clavicle
above is 2-3 X faster

therefore do the face first when injecting above and below the clavicle
hertel ophthalmometer
norm measurement
15 - 17 mm
> = exophthalmos
wide intracrural distance called
"boxy" tip
disadvantage of liposuction rx of macromastia
does not corredt ptosis
thromboembolism prophylaxis
enoxaparin and squential compressing devises
most common complication of latissimus dorsi flap
seroma
inferior oblique

action on eye
moves up and inward
superiod oblique
action on eye
down and inward
superior rectus
action on eye
up and out
inferior rectus
action on eye
down and out
tubular breast Rx
radial scoring of breast
nipple reduction
augmentation
ear reconstruction
temporal parietal flap (when available) covered autologous cartilage framework
entropion vs extropion

test to differentiate
activate orbiclaris muscle

(sometimes hard to tell in repose)
support of external nasal valve
alar rim ( lower lateral cartilage)
MRI recommendation to follow silicone implants
3 years post op & q 2 years thereafter
bet mech to decrease lymphedema in medial thigh lift
superficial dissection at femoral triangle
vessel to use for ear replantation
posterior auricular artery
Rx of unilateral recurrent severe capsule contracture
capsulectomy and autologous tissue reconstruction

(autolog tissue best for inhibiting scar, but ? choice for unilateral problem - other side will do the same thing)
advantage of microneural muscle transfer for facial palsy
(using cross facial n. gft)
spontaneous animation