Cosmetic and Facial Plastic Surgery

Question 1

Depression at the root of the nose corresponding to the nasofrontal suture

Answer 1

Nasion

Question 2

What is the soft tissue equivalent of the nasion?

Answer 2

Sellion

Question 3

Incision over the caudal edge of the lateral crura of the lower lats

Answer 3

Marginal

Question 4

Where are lateral osteotomies performed after bony hump is removed in rhinoplasty?

Answer 4

Pyriform aperature on the ascending process of the maxilla at the level of the lateral attachment of the interior turbinate

Question 5

Major tip support mechanisms

Answer 5

1. Strength of the lower lateral cartilage
2. Attachment of the medial crura of the LLC to the septum
3. Attachment of the upper to the lower lateral cartilage

Question 6

What are the minor tip support mechanisms?

Answer 6

1. Dorsal septum
2. Intermodal ligaments
3. Membranous septum
4. Nasal spine
5. Surrounding skin and soft tissues
6. Alar sidewalls

Question 7

What is a lateral crural steal?

Answer 7

Recruiting the lateral crura into the tip with horizontal mattress, making the medial crura relatively longer and the lateral crura shorter, increasing tip projection

Question 8

What kind of patient is at increased risk for inverted V deformity?

Answer 8

Short nasal bones with long ULCs

Question 9

What is the etiology of inverted V deformity?

Answer 9

Medial displacement of the ULCs with respect to the nasal bones–leads to the caudal border of the nasal bones becoming visible

Question 10

Internal nasal valve borders

Answer 10

Septum
Caudal ULC
Inferior turbinate
Floor of the nose

Question 11

Idea brow position in men vs women

Answer 11

Men: at the level of the orbital rim
Women: 1 cm superior to the orbital rim

Question 12

What is the term for excess skin in the upper or lower eyelids

Answer 12

Dermatochalasis

Question 13

Where is the inferior oblique found during blephroplasty?

Answer 13

Between the lower medial and central adipose pads

Question 14

What are the layers of the epidermis

Answer 14

Stratum corneum
Stratums lucidum
Stratum granulosum
Stratum spinosum
Stratum basale

Question 15

What is the difference between ablative and non-ablative lasers?

Answer 15

Ablative: Damage and remove skin like peels
Nonablative: Target the dermis and stimulate collagen remodeling, leaving the stratum corneum intact

Question 16

What is the difference between traditional non-fractional and newer fractional lasers?

Answer 16

Non-fractional: affect all of the skin in the treatment area

Fractional: Treat microcolumns called microthermal treatment zones (MTZ) and spare skin between mircocolumns

Question 17

What is the respective depth of skin affected by the following peels?

1. Very superficial
2. Superficial
3. Medium
4. Deep

Answer 17

1. Stratum corneum of the epidermis
2. Epidermis
3. Papillary dermis
4. Reticular dermis

Question 18

Ablative lasers target ___ within the skin as a chromophore

Answer 18

Water

Question 19

What does fluence describe?

Answer 19

Energy per unit area of a laser beam–higher fluence has more energy and deeper penetration

Question 20

How does Fitzpatrick type affect absorption of laser light?

Answer 20

Melanin can absorb laser light, increasing risk of laser burn
More conservative parameters should be used in patient with higher Fitzpatrick score

Question 21

What particular peel has systemic risks and shouldn’t be used in patients with pre-existing cardiac, renal, or hepatic disease?

Answer 21

Phenol

Question 22

How long after accutane is used are peels contraindicated?

Answer 22

6-12 mo, as it downregulates the adnexal structures in the dermis required for regeneration

Question 23

What should be started 1 mo prior to skin resurfacing in a patient with a history of hyperpigmentation or a higher fitzpatrick type

Answer 23

Topical hydroquione

Question 24

Prior to skin resurfacing, when should HSV 1 and 2 ppx be initiated?

Answer 24

2 days prior to procedure, regardless of infection hx