PracticeBlogFlashcardsEspañol
All Practice Exams

100+ Free ABPS Plastic Surgery Within the Head and Neck Practice Questions

Pass your ABPS Plastic Surgery Within the Head and Neck Subspecialty Certification Examination exam on the first try — instant access, no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
~80-90% first-time among fellowship-trained candidates (ABPS subspecialty statistics) Pass Rate
100+ Questions
100% Free
1 / 100
Question 1
Score: 0/0

Which branch of the facial nerve, when injured, has the LEAST potential for spontaneous recovery and is therefore considered most critical to identify and protect during parotidectomy?

A
B
C
D
to track
2026 Statistics

Key Facts: ABPS Plastic Surgery Within the Head and Neck Exam

~200

Total MCQ Items

ABPS Within the Head and Neck Subspecialty Examination

~6-8 hr

Total Exam Time

1-day computer-based test including breaks

~$2,200

2026 Subspecialty Fee

ABPS (verify current schedule)

ABMS

Recognized Subspecialty

Co-sponsored by ABPS and ABOHNS as an official ABMS subspecialty

Fellowship

Required Training

ACGME-accredited craniofacial or head and neck plastic surgery fellowship

~80-90%

First-Time Pass Rate

ABPS subspecialty statistics (fellowship-trained candidates)

ABPS Plastic Surgery Within the Head and Neck is a 1-day computer-based subspecialty certification exam from the American Board of Plastic Surgery (co-sponsored ABMS subspecialty with ABOHNS) comprising ~200 single-best-answer MCQs. Content spans facial anatomy and trauma (~18-22%), cleft lip and palate (~12-15%), pediatric craniofacial including craniosynostosis (~10-12%), rhinoplasty (~10%), facial reconstruction of Mohs and oncologic defects (~10-12%), head and neck oncologic free flap reconstruction (~12-14%), orthognathic surgery (~6-8%), facelift and blepharoplasty (~6-8%), microtia and ear reconstruction (~5-7%), salivary gland surgery (~3-5%), and scar revision and keloids (~3-5%). Subspecialty fee is ~$2,200; requires ABPS primary certification and an accredited craniofacial or related fellowship plus concentrated head and neck practice.

Sample ABPS Plastic Surgery Within the Head and Neck Practice Questions

Try these sample questions to test your ABPS Plastic Surgery Within the Head and Neck exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which branch of the facial nerve, when injured, has the LEAST potential for spontaneous recovery and is therefore considered most critical to identify and protect during parotidectomy?
A.Temporal (frontal) branch
B.Zygomatic branch
C.Buccal branch
D.Cervical branch
Explanation: The temporal (frontal) and marginal mandibular branches are considered terminal branches with the least cross-innervation, so injury results in the least spontaneous recovery. Buccal and zygomatic branches have extensive arborization and frequently recover function even after partial injury.
2The temporal branch of the facial nerve courses within which fascial plane as it crosses the zygomatic arch?
A.Deep to the deep temporal fascia
B.Within the temporoparietal (superficial temporal) fascia
C.Within the periosteum of the zygomatic arch
D.Between the deep and superficial layers of the deep temporal fascia
Explanation: The temporal branch travels within the temporoparietal fascia (superficial temporal fascia/SMAS continuation) as it crosses the zygomatic arch. Subperiosteal or sub-deep-temporal-fascia dissection over the arch protects the nerve. Pitanguy's line marks its surface course.
3The SMAS (superficial musculoaponeurotic system) of the face is continuous superiorly with which structure?
A.Deep temporal fascia
B.Temporoparietal fascia and frontalis
C.Periosteum of the zygomatic arch
D.Masseteric fascia
Explanation: The SMAS is continuous with the temporoparietal fascia superiorly, the frontalis above, the platysma inferiorly, and the SMAS extends as a fibromuscular layer enveloping facial mimetic muscles. The facial nerve branches lie deep to the SMAS.
4Which artery is the primary blood supply to the paramedian forehead flap used in nasal reconstruction?
A.Superficial temporal artery
B.Supratrochlear artery
C.Dorsal nasal artery
D.Angular artery
Explanation: The paramedian forehead flap is based on the supratrochlear artery, which exits the orbit approximately 1.7-2.2 cm from the midline at the level of the supraorbital rim. The supraorbital artery provides supplementary supply but the supratrochlear is the dominant pedicle.
5Sensation to the lower lip and chin is supplied by which nerve?
A.Infraorbital nerve (V2)
B.Mental nerve (V3)
C.Buccal branch of the facial nerve
D.Great auricular nerve
Explanation: The mental nerve, a terminal branch of the inferior alveolar nerve (V3 mandibular division of trigeminal), exits the mental foramen and supplies sensation to the lower lip, chin, and labial gingiva of the lower incisors.
6Per the classic Dingman and Grabb cadaver study, what percentage of the time does the marginal mandibular branch of the facial nerve travel BELOW the inferior border of the mandible posterior to the facial artery?
A.Approximately 5%
B.Approximately 19%
C.Approximately 50%
D.Approximately 81%
Explanation: Dingman and Grabb (1962) demonstrated that the marginal mandibular branch travels below the mandibular border in approximately 19% of cases posterior to the facial artery, but always lies above the border anterior to the facial artery. This is the basis for the Hayes Martin maneuver — ligating the facial vein high to retract the nerve superiorly.
7The white roll of the lip refers to which anatomic structure?
A.The Cupid's bow
B.The mucocutaneous junction at the vermilion-cutaneous border
C.The wet-dry vermilion line
D.The philtral column
Explanation: The white roll is the slightly elevated ridge at the vermilion-cutaneous junction. Precise alignment of the white roll is critical in lip laceration repair and cleft lip reconstruction — a 1 mm step-off is visible at conversational distance.
8A Le Fort II fracture is characterized by which fracture pattern?
A.Horizontal maxillary fracture above the alveolus, separating the palate from the upper midface
B.Pyramidal fracture through the nasofrontal suture, medial orbital walls, orbital floor, and zygomaticomaxillary buttress
C.Craniofacial dysjunction through the nasofrontal sutures, ethmoid, and zygomaticofrontal sutures
D.Sagittal split of the maxillary alveolus
Explanation: Le Fort II is the pyramidal fracture extending from the nasofrontal junction through the medial and inferior orbital walls and the zygomaticomaxillary buttresses, ending at the pterygoid plates. Le Fort I is horizontal (palate-separating); Le Fort III is craniofacial dysjunction.
9Which is the most commonly fractured anatomic location of the mandible in adults?
A.Symphysis
B.Body
C.Angle
D.Condyle/subcondylar region
Explanation: The condylar/subcondylar region is the most commonly fractured site (~30-35% of mandible fractures), followed by the body and angle. Condylar fractures are often missed and require careful evaluation with panoramic films or CT.
10A 9-year-old child presents after blunt facial trauma with persistent vomiting, bradycardia, severely restricted upgaze, and minimal external soft-tissue findings. CT shows a small linear orbital floor fracture. What is the most appropriate next step?
A.Outpatient ophthalmology follow-up in 1 week
B.Antibiotics and observation for 2 weeks before considering surgery
C.Urgent (within 24-48 hours) operative release of entrapped tissue
D.Steroid taper and re-imaging in 2 weeks
Explanation: This is the classic 'white-eyed blowout fracture' in a pediatric patient — minimal external signs but trapdoor entrapment of the inferior rectus with oculocardiac reflex (bradycardia, nausea, vomiting, syncope). Urgent operative release within 24-48 hours is required to prevent permanent ischemic necrosis of the entrapped muscle.

About the ABPS Plastic Surgery Within the Head and Neck Exam

The ABPS Plastic Surgery Within the Head and Neck Subspecialty Certification Examination is an ABMS subspecialty co-sponsored by the American Board of Plastic Surgery (ABPS) and the American Board of Otolaryngology-Head and Neck Surgery (ABOHNS), issued by ABPS for plastic surgery diplomates who completed an accredited fellowship and demonstrate concentrated practice in head and neck plastic surgery. Content spans facial anatomy (facial nerve, SMAS, vascular territories), craniofacial trauma (Le Fort, mandible, orbital, NOE, frontal sinus), cleft lip and palate (Millard, Furlow, alveolar bone graft, NAM, VPI), microtia and ear reconstruction (Brent/Nagata, Antia-Buch, prominent ear correction), rhinoplasty (spreader grafts, internal valve, cleft and revision), facial reconstruction of Mohs and oncologic defects (Burget subunits, paramedian forehead, Karapandzic, cervicofacial), orthognathic surgery (BSSO, Le Fort I, distraction, genioplasty), facelift and blepharoplasty (deep plane, transconjunctival, ectropion prevention), head and neck oncologic free flap reconstruction (fibula, ALT, radial forearm, scapular system, jejunum), pediatric craniofacial surgery (craniosynostosis, syndromic FGFR2/TWIST1/TCOF1, hemifacial microsomia, ISSVA vascular anomalies), salivary gland surgery (parotidectomy, Frey syndrome, mucoepidermoid carcinoma), and scar revision and keloid management.

Questions

200 scored questions

Time Limit

1-day CBT (~6-8 hours including breaks)

Passing Score

Criterion-referenced scaled score set by ABPS (modified Angoff standard)

Exam Fee

~$2,200 Subspecialty Certification fee (ABPS 2026 — verify current schedule) (American Board of Plastic Surgery (ABPS) — co-sponsored ABMS subspecialty with ABOHNS / Pearson VUE)

ABPS Plastic Surgery Within the Head and Neck Exam Content Outline

~18-22%

Facial Anatomy & Craniofacial Trauma

Facial nerve branches and danger zones (Pitanguy line, marginal mandibular per Dingman-Grabb), SMAS and temporoparietal fascia, sensory nerves (supratrochlear, infraorbital, mental, great auricular at McKinney's point), Le Fort I/II/III, ZMC tripod fractures, mandible (subcondylar most common; Zide ORIF criteria), white-eyed pediatric blowout (urgent within 24-48 hr), NOE Markowitz I/II/III with telecanthus, frontal sinus (anterior/posterior table, nasofrontal outflow), panfacial sequencing (bottom-up, inside-out), septal hematoma I&D.

~12-15%

Cleft Lip & Palate

Millard rotation-advancement and Tennison-Randall for cleft lip; Rule of Tens (≥10 weeks, ≥10 lb, Hgb ≥10 g/dL); Furlow double-opposing Z, von Langenbeck, two-flap palatoplasty; greater palatine artery pedicle; secondary alveolar bone graft at mixed dentition (8-11 yr) before canine eruption; VPI work-up and procedure selection (pharyngeal flap vs sphincter pharyngoplasty vs Furlow conversion); Pierre Robin (micrognathia, glossoptosis, airway); NAM (Grayson) at 1-2 weeks; multifactorial recurrence ~4%.

~10-12%

Pediatric Craniofacial & Craniosynostosis

Single-suture synostosis (sagittal scaphocephaly most common ~50%, metopic trigonocephaly, coronal plagio/brachycephaly, lambdoid); endoscopic strip + helmet at 3-4 mo vs open vault remodeling at 9-12 mo; syndromic FGFR2 (Crouzon, Apert, Pfeiffer), Apert mitten syndactyly, Treacher Collins TCOF1, Saethre-Chotzen TWIST1; OMENS hemifacial microsomia and Pruzansky-Kaban mandible; positional vs lambdoid (parallelogram vs trapezoid); midline nasal mass MRI before biopsy; ISSVA — propranolol for IH; multisuture/syndromic ICP risk.

~10%

Rhinoplasty

Anderson's three major tip support mechanisms; spreader grafts to restore middle vault and open internal nasal valve (~10-15° normal); columellar strut and septal extension grafts; polly-beak and inverted-V deformity; nasal valves (internal — caudal upper lateral, dorsal septum, inferior turbinate, floor; external — alar margin); cleft secondary rhinoplasty deferred to skeletal maturity; Asian dorsal augmentation with autologous costal cartilage (Gibson concentric carving to mitigate warping).

~10-12%

Facial Reconstruction (Mohs, Trauma, Oncologic Defects)

Burget-Menick subunit principle (>50% → reconstruct entire subunit); paramedian forehead flap on supratrochlear artery (~1.7-2.2 cm from midline); pedicle division at ~3 weeks (or 3-stage Menick at 6-7 weeks); Karapandzic for ≤60-80% lower lip defects; Estlander/Abbe/Bernard-Webster; cervicofacial advancement-rotation; bilobed Zitelli ~100-110° total; Tenzel and Mustardé eyelid; Hughes tarsoconjunctival; septal mucoperichondrial hinge flap (septal branch of superior labial); Orticochea scalp; galeotomies.

~12-14%

Head & Neck Oncologic Free Flap Reconstruction

Free fibula (peroneal artery; up to ~25 cm; 3-vessel runoff CTA); ALT (descending branch LCFA, ~85% musculocutaneous through vastus lateralis); radial forearm (Allen test mandatory); scapular/parascapular system (circumflex scapular, chimeric subscapular); facial artery most common recipient; venous thrombosis most common cause of failure; total glossectomy bulky ALT/rectus; Brown class IIb maxillectomy; tubed RFFF/ALT vs jejunum (jejunum gurgling speech); ORN Notani III → segmental + free fibula; Marx HBO protocol; VSP and patient-specific guides.

~6-8%

Orthognathic Surgery

BSSO (inferior alveolar nerve risk; neurosensory disturbance ~30-85% temporary, ~10-30% persistent); Le Fort I osteotomy above root apices (descending palatine artery, AVN of segments); distraction osteogenesis (latency 5-7 d, rate 1 mm/day, consolidation ~6-8 wk); sliding genioplasty (mental nerve at risk; osteotomy ≥5 mm below mental foramen); Angle classification (Class I — mesiobuccal cusp upper molar in buccal groove of lower); cleft orthognathic before definitive rhinoplasty.

~6-8%

Facelift & Blepharoplasty

Deep-plane facelift releases zygomaticocutaneous and masseteric cutaneous ligaments; SMAS plication, lateral SMASectomy, MACS lift; hematoma most common early complication (~1-15%, men with HTN); great auricular nerve at McKinney's point; temporal branch most commonly injured facial nerve; upper blepharoplasty leaves ≥20 mm to brow; transconjunctival lower bleph reduces ectropion; Frost suture and canthopexy/canthoplasty for laxity; BTX cleaves SNAP-25; HA filler vision loss requires immediate hyaluronidase; tobacco ~12× skin necrosis.

~5-7%

Microtia & Ear Reconstruction

Autologous costal cartilage techniques (Brent ~age 6, Nagata ~age 10) vs Medpor (age 3-4); auricle blood supply (posterior auricular and superficial temporal arteries); Mustardé sutures (recreate antihelical fold) and Furnas conchomastoid for prominent ear; Stenström anterior cartilage scoring; Antia-Buch chondrocutaneous helical advancement (≤2 cm); composite grafts for small defects; microtia association with hemifacial microsomia (OMENS) and Treacher Collins (TCOF1).

~3-5%

Salivary Gland Surgery

Pleomorphic adenoma most common benign parotid tumor (superficial parotidectomy, never enucleate); mucoepidermoid carcinoma most common parotid malignancy in adults (acinic in children; adenoid cystic — perineural/late distant); facial nerve identification (tragal pointer ~1 cm deep/inferior, tympanomastoid suture, posterior belly of digastric); Frey syndrome (auriculotemporal aberrant reinnervation; BTX-A most effective); acute suppurative parotitis (S. aureus in dehydrated postoperative elderly).

~3-5%

Scar Revision & Keloids

Keloid (extends beyond wound, common earlobe/chest/upper back, pigmented skin) vs hypertrophic (within wound, may regress); excision + intralesional triamcinolone + pressure earring + adjuvant low-dose RT for recurrent; Z-plasty lengthening (60° → 75% theoretical); W-plasty/geometric broken line for camouflage without lengthening; RSTLs perpendicular to underlying muscle fibers; silicone sheeting and 5-FU adjuncts; serial excision and tissue expansion for large facial scars.

How to Pass the ABPS Plastic Surgery Within the Head and Neck Exam

What You Need to Know

  • Passing score: Criterion-referenced scaled score set by ABPS (modified Angoff standard)
  • Exam length: 200 questions
  • Time limit: 1-day CBT (~6-8 hours including breaks)
  • Exam fee: ~$2,200 Subspecialty Certification fee (ABPS 2026 — verify current schedule)

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ABPS Plastic Surgery Within the Head and Neck Study Tips from Top Performers

1Memorize Markowitz NOE classification: Type I — single large central segment with medial canthal tendon attached (ORIF of central fragment); Type II — comminuted central segment but MCT attached to a usable bone fragment (ORIF + buttressing graft); Type III — MCT avulsed from bone (transnasal canthopexy + bone graft). Normal intercanthal distance ~30-35 mm; >40 mm = telecanthus.
2Syndromic craniosynostosis genes (high-yield): Crouzon, Apert, Pfeiffer = FGFR2 (Pfeiffer also FGFR1). Apert is distinguished by complex 'mitten' syndactyly. Treacher Collins = TCOF1 (autosomal dominant; mandibulofacial dysostosis with down-slanting palpebrals, lower lid coloboma, microtia). Saethre-Chotzen = TWIST1. Pierre Robin triad = micrognathia + glossoptosis + cleft palate (airway management — prone, NPA, tongue-lip adhesion, mandibular distraction, tracheostomy).
3Free fibula reconstruction pearls: peroneal artery pedicle, up to ~25 cm of bicortical bone amenable to multiple osteotomies, septocutaneous and musculocutaneous skin paddle. Mandatory preoperative angiography or CTA to confirm three-vessel runoff to the foot — fibula harvest requires intact anterior tibial and posterior tibial arteries. Workhorse for segmental mandibular and maxillary buttress reconstruction; VSP and patient-specific cutting guides improve accuracy and shorten ischemia time.
4Pediatric white-eyed blowout fracture is a true craniofacial emergency. A child with persistent vomiting, bradycardia (oculocardiac reflex), severely restricted upgaze, and minimal external soft-tissue findings on a small linear orbital floor fracture has trapdoor entrapment of the inferior rectus. Operative release is required within 24-48 hours to prevent permanent ischemic muscle necrosis. Adult orbital floor fractures are typically managed less urgently based on enophthalmos, diplopia, and defect size.
5Burget-Menick nasal subunit principle: when a defect involves >50% of an aesthetic subunit (tip, dorsum, sidewall, ala, soft triangle, columella), excise the entire subunit and reconstruct it as a whole. Paramedian forehead flap is supplied by the supratrochlear artery (~1.7-2.2 cm from midline at the supraorbital rim). Two-stage division at ~3 weeks; three-stage Menick (intermediate sculpting at 3 weeks, final division at 6-7 weeks) is preferred for full-thickness defects with cartilage grafting.

Frequently Asked Questions

What is the ABPS Plastic Surgery Within the Head and Neck Subspecialty Examination?

It is the ABMS subspecialty certification examination co-sponsored by the American Board of Plastic Surgery (ABPS) and the American Board of Otolaryngology-Head and Neck Surgery (ABOHNS). The examination is issued by ABPS for diplomates who completed primary certification in plastic surgery, finished an accredited craniofacial or head and neck plastic surgery fellowship, and demonstrate concentrated head and neck practice. Content spans cleft lip and palate, craniofacial trauma and craniosynostosis, rhinoplasty, microtia, facial reconstruction, orthognathic, facelift and blepharoplasty, head and neck oncologic free flap reconstruction, salivary gland surgery, and scar revision.

Who is eligible to take the Within the Head and Neck Subspecialty Examination?

ABPS-route candidates must hold valid ABPS Primary Certification in Plastic Surgery, have completed an ACGME-accredited craniofacial or related head and neck fellowship (or equivalent training pathway accepted by ABPS), demonstrate concentrated head and neck plastic surgery practice through case logs, hold a valid unrestricted medical license, and be in good standing with the ABPS Continuing Certification program. ABOHNS-route candidates apply through their primary board. Candidates must adhere to the ABPS Code of Ethics and Professionalism.

What is the format and length of the exam?

The Within the Head and Neck Subspecialty Examination is a 1-day computer-based examination administered at Pearson VUE test centers, comprising approximately 200 single-best-answer multiple-choice questions over roughly 6-8 hours including breaks. Items frequently include clinical photographs, CT and 3D craniofacial imaging, intraoperative photos, and pathology specimens. The exam is blueprinted to the joint ABPS-ABOHNS subspecialty content outline and mirrors the depth of fellowship-level practice.

How much does the 2026 subspecialty exam cost?

The 2026 ABPS Plastic Surgery Within the Head and Neck Subspecialty Certification fee is approximately $2,200 — always verify the current schedule on the ABPS examinations page. Cancellation and refund policies follow the published ABPS schedule, with decreasing refunds as the exam date approaches. Retakes require re-registration, full fee payment, and remain subject to the ABPS subspecialty eligibility window. Maintenance of subspecialty certification requires participation in the ABPS Continuing Certification program.

How is the exam scored?

ABPS uses criterion-referenced scaled scoring with a passing standard set by subject-matter experts using the modified Angoff method. A candidate's pass or fail result is based on performance against a fixed cut-score set by content experts, not on a curve relative to other candidates. Score reports include domain-level feedback so that diplomates and fellowship programs can identify content gaps for retake preparation or continuing education.

What are the highest-yield topics for the subspecialty exam?

Highest-yield topics include facial nerve danger zones and SMAS anatomy, Le Fort I/II/III and ZMC fracture management, white-eyed pediatric orbital trapdoor (urgent release within 24-48 hours), Markowitz NOE classification, Millard cleft lip and Furlow palatoplasty, NAM and VPI work-up, FGFR2 syndromic craniosynostosis (Crouzon, Apert, Pfeiffer) and TCOF1 Treacher Collins, sagittal vs metopic vs unicoronal patterns, ISSVA vascular anomalies and propranolol for IH, Burget-Menick subunit principle, paramedian forehead flap pedicle anatomy, free fibula peroneal artery and three-vessel runoff CTA, ALT LCFA descending branch perforators, Frey syndrome and tragal pointer landmark, and keloid combined excision-RT-steroid management.

How should I study for the Within the Head and Neck subspecialty exam?

Use the ABPS-ABOHNS subspecialty content outline as a blueprint. Begin with anatomy (facial nerve, SMAS, vascular territories), then craniofacial trauma, cleft lip and palate, syndromic craniosynostosis, rhinoplasty (functional and cleft), Mohs and oncologic facial reconstruction, head and neck microsurgery (fibula, ALT, RFFF, scapular system), orthognathic surgery, facelift and blepharoplasty, microtia, salivary gland surgery, and scar/keloid management. Integrate Mathes and Hentz, Neligan, Mulliken-Robin's Comprehensive Cleft Care, and ISSVA classification updates with high-volume MCQ practice and fellowship case logs. Complete 1-2 timed full-length mocks.

How does this exam differ from primary ABPS Plastic Surgery certification?

The primary ABPS Plastic Surgery Written Examination is a broad ~250-question test covering all of plastic surgery (breast, hand, flaps, burns, oncology, aesthetics, head and neck, trunk, and lower extremity). The Within the Head and Neck Subspecialty Examination is a focused ~200-question test at fellowship-level depth across head and neck domains only — requiring ABPS primary certification first, then an accredited fellowship and concentrated practice. The subspecialty cert is co-sponsored with ABOHNS and recognized by ABMS as a formal subspecialty.