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Were modern saline breast implants first introduced in the United States in 1964?
Answer: False
Explanation: Modern saline breast implants were first introduced in France in 1964 by Laboratoires Arion, not initially in the United States.
Did the Cronin-Gerow implant, an early silicone-gel implant, utilize a Dacron fastener for rotational stability?
Answer: True
Explanation: Yes, the Cronin-Gerow implant, a first-generation silicone-gel implant, incorporated a Dacron fastener to secure it within the implant pocket and prevent rotation.
Did second-generation breast implants, characterized by thicker shells and more cohesive gel, result in a reduction of complications compared to their predecessors?
Answer: False
Explanation: Second-generation implants featured thinner shells and less cohesive gel for a more natural feel, but this design led to increased rates of rupture and leakage, contrary to the premise of fewer complications.
Was the polyurethane foam coating on certain second-generation implants intended to mitigate, rather than increase, the risk of capsular contracture?
Answer: True
Explanation: The polyurethane foam coating was applied to reduce the incidence of capsular contracture by eliciting an inflammatory response that hindered capsule formation.
Do fifth-generation silicone gel implants employ a semi-solid gel formulation engineered to preclude leakage and migration?
Answer: True
Explanation: Indeed, fifth-generation silicone gel implants are characterized by a semi-solid gel formulation that significantly minimizes the potential for filler leakage and migration.
Did concerns regarding platinum toxicity from silicone implant manufacturing prompt the FDA to mandate increased platinum levels in implants?
Answer: False
Explanation: Concerns about platinum toxicity were raised, but the FDA's review found little evidence of risk, and there was no mandate for increased platinum levels; rather, the focus was on assessing potential risks.
When were modern saline breast implants first introduced?
Answer: 1964
Explanation: Modern saline breast implants were first introduced in 1964.
Who invented the modern prosthetic breast implant, and who manufactured it?
Answer: Thomas Cronin and Frank Gerow, manufactured by Dow Corning Corporation.
Explanation: The modern prosthetic breast implant was invented by Thomas Cronin and Frank Gerow, and subsequently manufactured by Dow Corning Corporation.
What was a significant drawback of second-generation breast implants?
Answer: They were more fragile, resulting in higher rates of rupture and leakage.
Explanation: A significant drawback of second-generation implants was their increased fragility, which led to higher incidences of shell rupture and filler leakage.
The polyurethane foam coating on some second-generation implants was associated with concerns about which carcinogenic substance?
Answer: Toluene diamine (TDA).
Explanation: Concerns regarding the carcinogenic substance 2,4-toluene diamine (TDA) were associated with the polyurethane foam coating used on some second-generation implants.
Are saline and silicone gel the only types of fillers utilized in breast implants?
Answer: False
Explanation: While saline solution and silicone gel are the most prevalent fillers, historical and alternative compositions have been employed.
Which of the following are the two primary methods used for breast augmentation?
Answer: Breast implants and fat-graft transfer.
Explanation: The two principal methods for breast augmentation involve the use of breast implants (saline or silicone) and the transfer of autologous fat.
What materials are most commonly used as fillers in modern breast implants?
Answer: Sterile saline solution and silicone gel.
Explanation: Modern breast implants are predominantly filled with either sterile saline solution or silicone gel.
Which category of breast implants utilizes nested silicone rubber shells filled with saline solution?
Answer: Structured implants.
Explanation: Structured implants are characterized by nested silicone rubber shells containing saline solution between them.
Compared to silicone-gel implants, saline implants are more prone to which cosmetic issue?
Answer: Rippling or wrinkling of the skin.
Explanation: Saline implants may present with more noticeable skin rippling or wrinkling compared to silicone-gel implants, particularly in patients with minimal native breast tissue.
Are periareolar incisions the least likely approach to cause breastfeeding difficulties or impact nipple sensation?
Answer: False
Explanation: Periareolar incisions are among the approaches more likely to cause breastfeeding difficulties and affect nipple sensation due to potential damage to milk ducts and nerves.
Is the transumbilical (TUBA) approach suitable for the placement of pre-filled silicone-gel implants, owing to its minimal incision requirements?
Answer: False
Explanation: The transumbilical (TUBA) approach is generally not suitable for pre-filled silicone-gel implants due to the small incision size, which poses a risk to the implant shell during insertion.
Does the inframammary fold (IMF) incision necessitate a longer incision and potentially yield more visible scars relative to alternative methods?
Answer: True
Explanation: Yes, the inframammary fold (IMF) incision typically requires a longer incision and may result in slightly more noticeable scarring compared to certain other surgical approaches.
Does subglandular implant placement provide superior coverage for the superior aspect of the implant relative to submuscular placement?
Answer: False
Explanation: Submuscular or dual plane placement generally offers better coverage for the upper portion of the implant compared to purely subglandular placement, particularly in patients with limited native tissue.
Does the 'dual plane' technique entail positioning the entire implant beneath the pectoralis major muscle?
Answer: False
Explanation: No, the 'dual plane' technique involves placing the implant partially beneath the pectoralis major muscle and partially in the subglandular plane, offering enhanced coverage for the upper pole.
Is submuscular implant placement a technique employed to decrease the incidence of capsular contracture?
Answer: True
Explanation: Yes, submuscular implant placement is recognized as a surgical approach that can help reduce the likelihood of capsular contracture compared to subglandular placement.
What was a key technical goal of the saline-implant technique regarding surgical incisions?
Answer: To enable insertion through a smaller incision for less invasive procedures.
Explanation: A primary technical objective of the saline-implant technique was to facilitate insertion through smaller incisions, thereby reducing invasiveness and scar visibility.
Which surgical incision type is noted for potentially severing milk ducts and nerves, impacting breastfeeding and nipple sensation?
Answer: Periareolar incision.
Explanation: The periareolar incision, made around the areola, carries a notable risk of severing milk ducts and nerves, potentially affecting breastfeeding capability and nipple sensation.
Which implant placement technique involves placing the implant partially under the pectoralis major muscle and partially in the subglandular plane?
Answer: Dual plane (subpectoral) placement.
Explanation: The dual plane (subpectoral) placement technique positions the implant partially beneath the pectoralis major muscle and partially within the subglandular plane.
What is a potential drawback of the 'dual plane' or subpectoral implantation technique?
Answer: Excessive implant movement or 'animation deformity.'
Explanation: A potential drawback of the 'dual plane' or subpectoral implantation technique is the possibility of excessive implant movement, often referred to as 'animation deformity.'
Breast augmentation is exclusively performed for cosmetic enhancement.
Answer: False
Explanation: The procedure, augmentation mammoplasty, serves both cosmetic and reconstructive purposes, addressing issues such as congenital defects and post-surgical restoration, not solely aesthetic enhancement.
Do studies indicate that women seeking breast augmentation frequently present with underlying psychological issues, and does the procedure itself fail to enhance psychological well-being?
Answer: False
Explanation: Research suggests that underlying psychological factors may be present in women seeking augmentation, yet the procedure often correlates with improvements in psychological well-being.
Has breast augmentation surgery been definitively proven to directly elevate a woman's risk of suicide?
Answer: False
Explanation: While some studies show a correlation, definitive proof of a direct causal link between breast augmentation surgery and increased suicide risk has not been established; rather, pre-existing vulnerabilities are often implicated.
Are hematoma and seroma complications exclusive to breast augmentation surgery?
Answer: False
Explanation: Hematoma and seroma are common surgical complications that can occur after various procedures, not exclusively breast augmentation.
Was the 2019 recall of Allergan BIOCELL implants linked to a specific type of cancer affecting the immune system?
Answer: True
Explanation: Yes, the 2019 recall of Allergan BIOCELL textured implants was linked to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a cancer of the immune system.
Are saline implant ruptures typically more difficult to detect than silicone-gel implant ruptures?
Answer: False
Explanation: Conversely, saline implant ruptures are generally easier to detect as they deflate promptly, whereas silicone-gel implant ruptures may not cause immediate deflation and can be harder to identify without imaging.
Define capsular contracture: is it a condition where the implant shell thickens and tightens around the implant?
Answer: True
Explanation: Capsular contracture is indeed defined as the tightening and thickening of the fibrous scar tissue capsule that forms around a breast implant, potentially causing distortion and discomfort.
Have large-scale epidemiological studies established a causal link between silicone-gel breast implants and autoimmune diseases like fibromyalgia?
Answer: False
Explanation: Extensive epidemiological research has generally not supported a causal link between silicone-gel breast implants and systemic or autoimmune diseases like fibromyalgia.
Does radiotherapy treatment for breast cancer in augmented breasts typically reduce the incidence of medical complications?
Answer: False
Explanation: Conversely, radiotherapy for breast cancer in augmented breasts typically increases the incidence of medical complications, such as capsular contracture and infection.
What is a common psychological factor sometimes observed in women seeking breast augmentation, though the procedure often improves well-being?
Answer: Body dysmorphia.
Explanation: Body dysmorphia is a psychological factor sometimes observed in individuals seeking breast augmentation, although the procedure frequently leads to enhanced psychological well-being.
Which of the following is NOT a commonly reported improvement in quality of life after breast augmentation?
Answer: Enhanced financial stability.
Explanation: While improvements in self-confidence, sexual functioning, and appearance are commonly reported post-augmentation, enhanced financial stability is not typically associated with the procedure.
The prevailing interpretation of studies correlating breast augmentation with suicide risk suggests:
Answer: Women with pre-existing psychological vulnerabilities are more likely to seek augmentation.
Explanation: The prevailing interpretation posits that women with pre-existing psychological vulnerabilities may be more inclined to seek breast augmentation, rather than the surgery directly increasing suicide risk.
Which of the following is a complication *specific* to breast augmentation surgery, as opposed to general surgical complications?
Answer: Impaired breastfeeding function.
Explanation: Impaired breastfeeding function is a complication specifically associated with breast augmentation surgery, distinct from general surgical risks like hematoma, infection, or anesthetic reactions.
How does the rupture of a saline implant typically differ from a silicone-gel implant rupture in terms of detection?
Answer: Saline ruptures cause immediate deflation and are easily detected.
Explanation: Saline implant ruptures typically result in immediate deflation, making them readily detectable, whereas silicone-gel implant ruptures often do not cause deflation and are more challenging to identify without imaging.
What is capsular contracture?
Answer: The natural scar tissue capsule around an implant tightening and compressing it.
Explanation: Capsular contracture is the pathological tightening and thickening of the fibrous capsule that forms around a breast implant, potentially leading to distortion and pain.
Which of the following is a method used to *reduce* the incidence of capsular contracture?
Answer: Minimizing handling of implants and irrigating the site with antibiotic solutions.
Explanation: Practices such as minimizing implant handling and irrigating the surgical site with antibiotic solutions are employed to reduce the incidence of capsular contracture.
Scientific reviews have generally concluded that there is no causal link between silicone-gel breast implants and which condition?
Answer: Systemic or autoimmune diseases.
Explanation: Scientific reviews have predominantly concluded that no causal link exists between silicone-gel breast implants and systemic or autoimmune diseases.
What specific complication was linked to Allergan BIOCELL textured breast implants in 2019, leading to their recall?
Answer: Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
Explanation: The 2019 recall of Allergan BIOCELL textured breast implants was specifically linked to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
Which of the following is NOT listed as a suspected mechanism for breast implant rupture?
Answer: Excessive heat exposure during sterilization.
Explanation: Excessive heat exposure during sterilization is not typically listed as a suspected mechanism for breast implant rupture; damage during implantation, chemical degradation, and physical trauma are.
Is autologous fat grafting primarily utilized for correcting congenital defects and enhancing soft-tissue coverage over existing implants?
Answer: True
Explanation: Autologous fat grafting is indeed employed for correcting congenital defects, improving soft-tissue coverage over implants, and for general breast augmentation.
Is centrifugation employed to refine autologous fat tissue, specifically by separating viable adipocytes from blood products and lipids?
Answer: True
Explanation: Yes, centrifugation is a standard method for refining harvested autologous fat tissue, isolating the viable adipocytes from non-viable cellular components and fluids.
Is fat necrosis, a potential complication of fat grafting, considered an outcome that improves the aesthetic result?
Answer: False
Explanation: Fat necrosis is a potential complication of fat grafting that detracts from, rather than improves, the aesthetic outcome, as it represents non-viable tissue.
Is there any evidence suggesting that fat grafting increases the risk of developing breast cancer?
Answer: False
Explanation: Current scientific evidence does not indicate that autologous fat grafting increases the risk of developing breast cancer.
What is the primary benefit of using autologous fat grafts for breast augmentation compared to implants?
Answer: Avoidance of implant-related complications like rupture or contracture.
Explanation: A primary benefit of autologous fat grafting is the avoidance of complications specifically associated with breast implants, such as rupture or capsular contracture.
What is a potential limitation of fat grafting for breast augmentation compared to implants?
Answer: The achievable volume increase per session is typically limited.
Explanation: A notable limitation of fat grafting for breast augmentation is that the volume increase achievable per session is generally restricted, unlike the potential volume offered by implants.
How can fat grafting affect the detection of breast cancer through mammography?
Answer: It can cause calcifications or alter tissue density, potentially complicating detection.
Explanation: Fat grafting can introduce changes such as calcifications or altered tissue density, which may complicate the interpretation of mammograms and potentially obscure the detection of breast cancer.
What is the primary mechanism of external vacuum tissue expansion for breast volume enhancement?
Answer: Applying controlled negative pressure to stimulate tissue growth.
Explanation: External vacuum tissue expansion functions by applying controlled negative pressure, which stimulates the gradual growth of the breast tissue.
What are the most frequent radiologic changes observed after fat grafting to the breast?
Answer: Oil cysts and calcifications.
Explanation: The most commonly observed radiologic changes following fat grafting to the breast include the formation of oil cysts and calcifications.
Are breast implants generally considered biologically inert, posing no chemical risk during breastfeeding?
Answer: True
Explanation: While generally considered biologically inert, concerns regarding potential chemical transfer during breastfeeding persist, although definitive causality has not been established.
Is augmentation mammoplasty utilized solely for the aesthetic enhancement of breast size?
Answer: False
Explanation: Augmentation mammoplasty serves multiple purposes, including reconstructive procedures to address congenital defects or post-surgical restoration, in addition to aesthetic enhancement.
Does the FDA recommend that breast implants be considered lifetime devices?
Answer: False
Explanation: The FDA emphasizes that breast implants are not designed as lifetime devices and are associated with potential complications that may necessitate revision surgery over time.
Does the FDA recommend that breast implants be considered lifetime devices?
Answer: False
Explanation: The FDA explicitly states that breast implants are not designed as lifetime devices and are associated with potential complications that may necessitate revision surgery over time.
What is the primary purpose of breast augmentation?
Answer: To increase breast size, alter shape, or improve texture for cosmetic or reconstructive reasons.
Explanation: The primary purpose of breast augmentation encompasses both aesthetic enhancement of size, shape, and texture, and reconstructive applications for congenital defects or post-surgical restoration.
What is the typical re-operation rate for breast reconstruction patients at the 10-year mark, compared to cosmetic augmentation patients?
Answer: Higher for reconstruction patients (50%) than cosmetic patients (20%).
Explanation: At the 10-year mark, breast reconstruction patients typically exhibit a higher re-operation rate (around 50%) compared to cosmetic augmentation patients (around 20%).
The U.S. FDA recommends scheduled MRI examinations for screening silicone breast implant rupture, typically starting how long after implantation?
Answer: Three years post-implantation.
Explanation: The U.S. FDA recommends initiating scheduled MRI examinations for screening silicone breast implant rupture approximately three years after the initial implantation.