ABPS ABPS Breast Surgery & Oncoplastic Reconstruction 1 — Questions and Answers
Question 1: Which implant placement plane is most commonly associated with capsular contracture in breast augmentation?
- Subglandular (Correct answer)
- Subfascial
- Dual-plane
- Submuscular
Correct answer: Subglandular
Subglandular placement has higher capsular contracture rates compared to submuscular or dual-plane positioning.
Question 2: What classification system is used to grade capsular contracture after breast augmentation?
- TNM staging
- Baker classification (Correct answer)
- Spear grading
- Regnault scale
Correct answer: Baker classification
The Baker classification (Grades I–IV) is the standard system for grading the severity of capsular contracture.
Question 3: In nipple-sparing mastectomy, which factor most significantly increases the risk of nipple necrosis?
- Implant size > 300 cc
- Ptotic breast with long nipple-to-IMF distance (Correct answer)
- Subpectoral implant placement
- Saline implant use
Correct answer: Ptotic breast with long nipple-to-IMF distance
A ptotic breast with a long nipple-to-inframammary fold distance creates vascular compromise to the nipple-areola complex.
Question 4: The TRAM flap for breast reconstruction is primarily based on which vascular pedicle?
- Thoracodorsal artery
- Superior epigastric artery
- Deep inferior epigastric artery (Correct answer)
- Lateral thoracic artery
Correct answer: Deep inferior epigastric artery
The free TRAM flap is based on the deep inferior epigastric artery (DIEA), providing superior perfusion compared to the pedicled variant.
Question 5: Which FDA-approved breast implant surface texture has been most closely linked to breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?
- Smooth
- Microtextured
- Macrotextured (Correct answer)
- Polyurethane-coated
Correct answer: Macrotextured
Macrotextured implants carry the highest reported incidence of BIA-ALCL compared to smooth or minimally textured devices.
Question 6: What is the primary advantage of the DIEP flap over the free TRAM flap for breast reconstruction?
- Shorter operative time
- Preservation of the rectus abdominis muscle (Correct answer)
- Larger flap volume
- Lower anastomosis failure rate
Correct answer: Preservation of the rectus abdominis muscle
The DIEP flap spares the rectus abdominis muscle entirely, reducing donor-site morbidity compared to the free TRAM flap.
ABPS ABPS Breast Surgery & Oncoplastic Reconstruction 1
Which implant placement plane is most commonly associated with capsular contracture in breast augmentation?