Plastics

Why leave the fascia on the muscle during the dissection? So you will have a strong layer of tissue to suture too.
What suture style do you use for weaker tissue? Figure of 8 because it has greater surface area and won't “cheese wire” the tissue.
What is Red Breast Syndrome? Type IV hypersensitivity (delayed) reaction to acellular dermal matrix.
What is the incidence of Tissue Expander infections? 7-10%
What is the blood supply to the pectoralis major muscle? Type V Mathes and Nahai flap. Dominant supply pectoral branch of thoracoacromial trunk. Segmental supply of IMA perforators.
What is pitanguys line?
What is pitanguys point?
Why is this patient going to bleed? Patients with uremia have platelet dysfunction.
Why smooth expanders? Because smooth implants have been associated with ALCL and the only link is previous textured tissue expanders?
What are the aesthetic units of the breast?
Liposuction – Will ask to thoroughly explain procedure. Asks if you are doing liposuction on neck and abdomen which do you infiltrate first? Neck first, because it is highly vascular (»abdomen) and will absorb local anesthesia before you get to abdomen. This way you are not having peak absorption of local anesthesia at the same time.
Why wait after infiltrating to start liposuction? For the onset of epinephrine. Onset time 8 minutes. Peak effect 26 minutes.
Primary venous drainage system of abdomen? - superficial system
What is blood supply to pectoralis major? pectoral branch from thoracalacromial trunk, IMA perforators
What is dual plane for breast implants?
Hematoma could be from surrounding tissue or from a vein clot and now leaking from flap

Strongest suture tech? vertical matress best suture tech for everting? horizontal matress
Most ischemic stitch? horizontal matress

What incision should you use to remove an implant placed for augmentation? You should go through an IMF incision even if the implant was placed in a different incision. This is because if you go through the nipple, you will create a retraction defect by going through all the breast tissue and making a new scar.
How can you prevent new capsular contracture after breast implant exchange? Switch planes from sub-glanudlar to sub-muscular. Switch from smooth to textured implants. Alloderm can also decrease the chance of capsular contracture.
What are the grades of capsular contracture? Grade I — the breast is normally soft and appears natural in size and shape, Grade II — the breast is a little firm, but appears normal, Grade III — the breast is firm and appears abnormal, Grade IV — the breast is hard, painful to the touch, and appears abnormal.
When you are making the keyhole for the new nipple in a breast reduction, why de-epilthaize? Incase the nipple becomes ischemic, you can thin it and graft it onto that surface.
Clip the artery or vein first on a flap? The artery first so the flap isn't engorged with blood

Unilateral DIEP Flap - where is the ideal perforator - from the medial row (more centrally) so it can perfuse more of the flap. A lateral row might not perfuse the contralateral side of the flap as well.
DIEP Flap - what perforator is more morbid, medial, middle or lateral row? he lateral row perforators much more morbid because you're going to transect nerves more laterally and this is going to deinnervate more muscle.