100+ Free ABPS Plastic Surgery Practice Questions

Pass your ABPS Plastic Surgery Primary Certification Written Examination exam on the first try — instant access, no signup required.

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~80-90% first-time among integrated residency graduates (ABPS annual statistics) Pass Rate

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Question 1

Score: 0/0

The inflammatory phase of wound healing transitions into the proliferative phase approximately when?

Day 21

Within 6 hours

Day 4-6 post-injury

After 3 months

to track

2026 Statistics

Key Facts: ABPS Plastic Surgery Exam

~250

Total MCQ Items

ABPS Plastic Surgery Written Examination

~8 hr

Total Exam Time

1-day computer-based test including breaks

~15-18%

Head & Neck Weight

Largest single domain on 2026 ABPS content outline

~$2,500

2026 Written Exam Fee

ABPS (verify current schedule)

6 yr

Integrated Residency

ACGME-accredited integrated plastic surgery pathway

~80-90%

First-Time Pass Rate

ABPS annual statistics (integrated graduates)

The ABPS Plastic Surgery Written Exam is a 1-day computer-based test from the American Board of Plastic Surgery comprising ~250 single-best-answer MCQs over ~8 hours at Pearson VUE. Content spans head and neck/craniofacial (~15-18%), breast (~12-14%), hand (~12-15%), flaps/microsurgery (~12-14%), burns/wound healing (~10-12%), cutaneous oncology (~8-10%), aesthetic surgery (~8-10%), trunk/lower extremity (~6-8%), pediatric plastic (~5-7%), grafts/tissue expansion (~5-6%), and ethics/safety (~3-5%). Written Examination fee is ~$2,500; requires completion of an ACGME-accredited plastic surgery residency.

Sample ABPS Plastic Surgery Practice Questions

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

1The inflammatory phase of wound healing transitions into the proliferative phase approximately when?

A.Day 21

B.Within 6 hours

C.Day 4-6 post-injury

D.After 3 months

Explanation: Wound healing phases: hemostasis (immediate), inflammatory (0-4 days, neutrophils then macrophages), proliferative (day 4-21 — fibroblasts, angiogenesis, epithelialization, type III collagen), and remodeling (day 21 to ~1 year — type III replaced by type I, scar reaches ~80% tensile strength).

2What is the predominant collagen type in a mature (remodeled) scar?

A.Type VII collagen

B.Type III collagen

C.Type IV collagen

D.Type I collagen

Explanation: Normal unwounded dermis is ~80% type I and ~20% type III. Early granulation tissue is relatively enriched in type III. During remodeling, type III collagen is gradually replaced by type I so the mature scar approaches the normal ~4:1 type I:III ratio (though never fully equivalent to native dermis).

3Which cytokine is most strongly implicated in the pathogenesis of hypertrophic scarring and keloid formation?

A.TNF-α

B.IL-10

C.TGF-β (especially TGF-β1)

D.IFN-γ

Explanation: TGF-β1 drives fibroblast proliferation and excess type I and III collagen deposition in hypertrophic scars and keloids. TGF-β3 is relatively anti-fibrotic. IFN-γ and IL-10 have anti-fibrotic activity, and intralesional steroid (triamcinolone) is a mainstay of treatment by suppressing fibroblast activity.

4What BEST distinguishes a keloid from a hypertrophic scar?

A.Hypertrophic scars are always pigmented

B.Keloid extends beyond the original wound margins

C.Keloids always regress with time

D.Hypertrophic scars contain only type IV collagen

Explanation: Keloids grow beyond the boundaries of the original wound and rarely regress. Hypertrophic scars remain within the wound margins and may partially regress over 1-2 years. Keloids show higher recurrence after simple excision and often require adjuvant therapy (steroid injection, pressure, silicone, radiation).

5The TIME principle for chronic wound bed preparation stands for Tissue, Infection/inflammation, Moisture balance, and which fourth element?

A.Edge of wound (non-advancing epithelium)

B.Elasticity

C.Erythema

D.Erosion depth

Explanation: TIME = Tissue management (debridement of nonviable tissue), Infection/Inflammation control, Moisture balance (neither too wet nor too dry), and Edge of wound (epithelial advancement, undermining). Addressing each element converts a chronic stalled wound into one capable of healing.

6Which mechanism is NOT a recognized effect of negative pressure wound therapy (NPWT)?

A.Removal of exudate and reduction of edema

B.Macrodeformation (wound contraction)

C.Microdeformation stimulating cell proliferation

D.Direct antibiotic delivery into tissue

Explanation: NPWT (wound VAC) works through macrodeformation (wound contraction), microdeformation at the foam interface (cellular stretch promoting proliferation and angiogenesis), fluid and exudate removal with edema reduction, and alterations to the wound environment. It does not directly deliver antibiotics, though instillation systems can deliver topical agents.

7Integra bilayer skin substitute consists of an outer silicone layer and an inner matrix made primarily of what?

A.Human keratinocytes on porcine submucosa

B.Bovine collagen with chondroitin-6-sulfate glycosaminoglycan

C.Autologous fibroblasts on polyglactin mesh

D.Processed human amniotic membrane

Explanation: Integra is a bilayer dermal regeneration template — a silicone pseudoepidermis over a bovine collagen and chondroitin-6-sulfate GAG scaffold. After neodermis matures in ~2-3 weeks, the silicone is removed and a thin split-thickness autograft is placed. Alloderm is acellular human dermal matrix; Dermagraft is neonatal fibroblasts on a bioabsorbable mesh.

8Which factor most commonly contributes to non-healing diabetic foot ulcers?

A.Chronic antihistamine use

B.Isolated hypoalbuminemia

C.Vitamin A deficiency

D.Peripheral neuropathy combined with peripheral arterial disease

Explanation: Diabetic foot ulcers are driven predominantly by peripheral sensory neuropathy (loss of protective sensation), combined with peripheral arterial disease, repetitive trauma or pressure, deformity (Charcot), and impaired immune/healing function. Optimal care addresses glucose control, offloading, debridement, vascular assessment/revascularization, and infection control.

9In the Mathes-Nahai classification, the latissimus dorsi muscle flap is which type?

A.Type V — one dominant pedicle plus secondary segmental pedicles

B.Type I — single vascular pedicle

C.Type II — dominant pedicle plus minor pedicle(s)

D.Type IV — segmental vascular pedicles

Explanation: Mathes-Nahai Type V = one dominant pedicle (thoracodorsal for latissimus) plus secondary segmental pedicles (paraspinal perforators). This allows the flap to be based either on the thoracodorsal vessels (most common) or as a reverse flap on the segmentals. Pectoralis major is also Type V.

10Which muscle is classically described as a Mathes-Nahai Type IV flap and therefore the LEAST reliable when transposed on a single pedicle?

A.Tensor fascia lata

B.Gracilis

C.Gluteus maximus

D.Sartorius

Explanation: Type IV muscles have segmental vascular pedicles without a dominant pedicle — sartorius and tibialis anterior are classic examples. Division of multiple segments compromises perfusion, limiting their arc and reliability as flaps. Gracilis is Type II, gluteus maximus is Type III, and TFL is Type I.

About the ABPS Plastic Surgery Exam

The ABPS Plastic Surgery Primary Certification Written Examination validates core knowledge for independent practice in plastic surgery. Content spans wound healing and flap biology, microsurgery and perforator flaps (DIEP, ALT, TAP, SGAP/IGAP), head and neck and craniofacial (cleft lip and palate, Le Fort fractures, craniofacial syndromes — Crouzon/Apert/Treacher Collins/Pierre Robin, craniosynostosis), breast surgery (reconstruction, reduction, augmentation, BIA-ALCL), hand and upper extremity (Dupuytren, tendon, scaphoid, brachial plexus, replantation), burns (Parkland, escharotomy, inhalation injury), cutaneous oncology (melanoma AJCC 8, SCC, BCC, DFSP, Merkel cell), aesthetic surgery (rhytidectomy, rhinoplasty, blepharoplasty, liposuction, injectables), trunk and lower extremity (component separation, Gustilo, pressure sores), and pediatric plastic (ISSVA vascular anomalies, hypospadias, congenital hand). Requires completion of an ACGME-accredited integrated plastic surgery residency (6 years) or an independent pathway.

Questions

250 scored questions

Time Limit

1-day CBT (~8 hours including breaks)

Passing Score

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

Exam Fee

~$2,500 Written Examination fee (ABPS 2026 — verify current schedule) (American Board of Plastic Surgery (ABPS) / Pearson VUE)

ABPS Plastic Surgery Exam Content Outline

~15-18%

Head & Neck / Craniofacial

Cleft lip (Millard, Tennison-Randall), cleft palate (Furlow double-opposing Z, von Langenbeck, two-flap), VPI (pharyngeal flap, sphincter pharyngoplasty), craniofacial syndromes (Crouzon/Apert/Pfeiffer FGFR1/2, Treacher Collins TCOF1, Pierre Robin triad, Saethre-Chotzen TWIST1), craniosynostosis (sagittal scaphocephaly most common, metopic trigonocephaly, coronal plagiocephaly/brachycephaly), orbital blowout and entrapment, mandibular (condylar, angle), Le Fort I/II/III, facial reanimation (gracilis + CFNG).

~12-15%

Hand & Upper Extremity

Dupuytren (collagenase Xiaflex, NA, open fasciectomy for PIP contracture), trigger finger (A1 pulley release), carpal tunnel, cubital tunnel, De Quervain, scaphoid (retrograde flow — proximal pole AVN), distal radius, scapholunate ligament/DISI, TFCC, boutonniere/swan-neck, flexor tendon zone II (Bruner incision, Kessler + epitendinous, Kleinert/Duran rehab), replantation indications (children, thumb, multiple digits), brachial plexus (Oberlin, spinal accessory to suprascapular).

~12-14%

Breast Surgery

Post-mastectomy reconstruction (tissue expander → implant; DIEP, PAP, TUG, LD; ADM for lower-pole support), nipple reconstruction, PMRT effects, BRCA and prophylactic mastectomy, BIA-ALCL (CD30+ ALCL — textured implants), breast reduction (Wise/inverted-T, vertical, SPAIR, Benelli; Schnur nomogram), gynecomastia (Simon grading), mastopexy, augmentation (inframammary/periareolar/axillary/TUBA; smooth vs textured; capsular contracture Baker I-IV).

~12-14%

Flaps, Microsurgery & Perforators

Mathes-Nahai I-V muscle flap classes, random vs axial, free vs pedicled, perforator flaps (DIEP, TAP, SGAP/IGAP, ALT, MSAP), lymphatic microsurgery (LVA, VLNT), angiosome, delay phenomenon, ischemia-reperfusion injury, anastomosis (end-to-end vs end-to-side, size mismatch), heparin/ASA/dextran pharmacology, flap failure timing (arterial early, venous midterm), leech therapy (ciprofloxacin prophylaxis for Aeromonas hydrophila), implantable Doppler, SPY/ICG fluorescence.

~10-12%

Burns & Wound Healing

Wound healing phases (inflammatory/proliferative/remodeling), collagen I:III scar ratio, hypertrophic vs keloid (TGF-β), chronic wounds (diabetic foot, VLU, pressure), TIME principles, NPWT/wound VAC, skin substitutes (Integra, Alloderm, Dermagraft), Parkland formula (4 mL/kg/%TBSA LR, half in first 8 hr), burn depth, escharotomy, compartment syndrome, inhalation injury (CO, cyanide — hydroxocobalamin), Curreri nutrition, early excision and grafting.

~8-10%

Cutaneous Oncology

Melanoma (Breslow, AJCC 8, SLNB ≥0.8-1.0 mm or high-risk thin; WLE margins — 0.5-1 cm T1, 1 cm T2, 2 cm T3/T4; adjuvant nivolumab/ipilimumab PD-1/CTLA-4), cutaneous SCC (Brigham Women's staging, high-risk features), BCC (Mohs for H-zone), DFSP (Mohs or wide excision, imatinib for COL1A1-PDGFB), Merkel cell (aggressive, SLNB, avelumab immunotherapy).

~8-10%

Aesthetic Surgery

Rhytidectomy (MACS, deep plane, SMAS, subcutaneous), blepharoplasty (upper — skin/muscle; lower — transcutaneous vs transconjunctival, fat-repositioning), rhinoplasty (open vs closed, osteotomies, spreader/columellar grafts), liposuction (tumescent Klein solution, lidocaine max 35-55 mg/kg, UAL/LAL), injectables (BTX, HA, CaHA, PLLA, PMMA; vascular compromise and necrosis — hyaluronidase for HA fillers).

~6-8%

Trunk & Lower Extremity

Abdominal wall (anterior/posterior component separation — Ramirez, TAR transversus abdominis release, Rives-Stoppa; synthetic vs biologic mesh), pressure sores (sacral, ischial, trochanteric myocutaneous flaps; ostectomy; bursectomy), lower extremity trauma (Gustilo-Anderson open fracture classification, MESS score, compartment syndrome fasciotomy, Gustilo IIIB soft-tissue coverage ideally <72 hr).

~5-7%

Congenital & Pediatric Plastic

Polydactyly (Wassel classification), syndactyly (Flatt), symbrachydactyly, radial/ulnar dysplasia (Bayne), Poland syndrome, Apert complex syndactyly, ISSVA vascular anomalies (GLUT1+ infantile hemangioma vs GLUT1− NICH/RICH; capillary port-wine — Sturge-Weber, GNAQ; venous, lymphatic, AVM — Schobinger staging), propranolol for problematic IH, sclerotherapy, hypospadias (MAGPI, TIP/Snodgrass).

~5-6%

Grafts & Tissue Expansion

Split- vs full-thickness skin grafts, take (imbibition, inosculation, revascularization), fat grafting (Coleman technique, ~50-70% survival), bone grafts (cortical vs cancellous), nerve grafts and conduits (autograft, allograft, PGA/collagen conduits), tissue expansion (base/height, expansion ratio, expander selection, complications — infection, exposure, necrosis).

~3-5%

Ethics, Safety & Scholarly

Informed consent, billing ethics, social media professionalism, WHO surgical safety checklist, never events, VTE risk (Caprini score) and mechanical/pharmacologic prophylaxis, biostatistics (sensitivity/specificity, PPV/NPV, NNT), research design (RCT, cohort, case-control, case series), evidence levels.

~2-3%

Genital / GU / Gender-Affirming

Hypospadias (distal/mid/proximal — MAGPI, TIP/Snodgrass, two-stage), vaginoplasty (penile inversion, intestinal), phalloplasty (radial forearm, ALT), chest masculinization top surgery, feminization procedures.

How to Pass the ABPS Plastic Surgery Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPS (modified Angoff standard)
Exam length: 250 questions
Time limit: 1-day CBT (~8 hours including breaks)
Exam fee: ~$2,500 Written Examination 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 Study Tips from Top Performers

1Memorize Mathes-Nahai muscle flap classification with archetypes: Type I single pedicle (tensor fascia lata, gastrocnemius); Type II dominant + minor (gracilis, trapezius); Type III two dominant pedicles (gluteus maximus, rectus abdominis); Type IV segmental (sartorius, tibialis anterior — most unreliable as flap); Type V one dominant + secondary segmental (latissimus dorsi, pectoralis major).

2Craniofacial syndrome genes — high-yield: Crouzon/Apert/Pfeiffer all FGFR2 (Pfeiffer also FGFR1). Apert distinguished by complex (mitten) syndactyly. Treacher Collins = TCOF1 (autosomal dominant, mandibulofacial dysostosis). Saethre-Chotzen = TWIST1. Pierre Robin triad = micrognathia + glossoptosis + cleft palate (airway first — prone positioning, mandibular distraction). Craniosynostosis: sagittal (scaphocephaly) most common, metopic (trigonocephaly), coronal (plagiocephaly unilateral, brachycephaly bicoronal).

3Parkland formula and burn resuscitation: 4 mL × kg × %TBSA (2nd/3rd degree only) of lactated Ringer's over 24 hours; half in the first 8 hours from time of burn (not presentation). Target urine output 0.5 mL/kg/hr in adults, 1 mL/kg/hr in children, 1-2 mL/kg/hr in electrical injury/myoglobinuria. Always evaluate for inhalation injury (bronchoscopy, CO — carboxyhemoglobin, cyanide — hydroxocobalamin) and circumferential burns requiring escharotomy.

4BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) is a CD30+ T-cell lymphoma associated with TEXTURED implants. Presents as a delayed periprosthetic seroma typically 8-10 years after implantation. Work-up: ultrasound-guided aspiration with cytology, CD30 IHC, flow cytometry, and cytogenetics. Treatment for disease confined to the capsule: en bloc capsulectomy and implant removal (often curative). Advanced disease: brentuximab vedotin ± chemotherapy.

5Melanoma AJCC 8 management pearls: WLE margins 0.5 cm (in situ), 1 cm (Breslow ≤1 mm), 1-2 cm (1-2 mm), 2 cm (>2 mm). SLNB offered for Breslow ≥0.8 mm (or <0.8 mm with ulceration/high-risk features). Stage III (LN+) consider adjuvant anti-PD-1 (nivolumab, pembrolizumab). Stage IV unresectable — combination ipilimumab + nivolumab or targeted therapy for BRAF V600E/K (dabrafenib + trametinib).

Frequently Asked Questions

What is the ABPS Plastic Surgery Written Examination?

The ABPS Plastic Surgery Primary Certification Written Examination is administered by the American Board of Plastic Surgery and is the first of two required examinations (Written, then Oral) for initial board certification. It validates breadth of knowledge across reconstructive and aesthetic plastic surgery including head and neck/craniofacial, breast, hand, flaps and microsurgery, burns and wound healing, cutaneous oncology, aesthetic surgery, trunk and lower extremity, pediatric plastic, and grafts/tissue expansion.

Who is eligible to take the ABPS Written Examination?

Candidates must complete an ACGME-accredited plastic surgery residency — either the integrated pathway (6 years of plastic surgery residency) or the independent pathway (completion of a general surgery residency or equivalent plus 3 years of plastic surgery residency). A valid unrestricted medical license is required, and the program director must attest to satisfactory performance and ethics.

What is the format of the ABPS Written Exam?

The ABPS Written Exam is a 1-day computer-based examination administered at Pearson VUE test centers, comprising approximately 250 single-best-answer multiple-choice questions over roughly 8 hours including breaks. Items commonly include clinical photographs, imaging, and intraoperative images. The exam is blueprinted to the ABPS content outline spanning head and neck, breast, hand, flaps/microsurgery, burns, oncology, aesthetics, and related domains.

How much does the 2026 ABPS Written Exam cost?

The 2026 ABPS Written Examination fee is approximately $2,500 — always verify the current schedule on the ABPS website. Candidates also pay a separate Oral Examination fee (~$2,600) after passing Written. Cancellation and refund policies follow the ABPS schedule with decreasing refunds as the exam date approaches. Retakes require re-registration and full fee payment within the allowed qualification window.

When is the 2026 exam administered?

The ABPS Written Examination is typically offered once annually in the fall. Applications generally open in the spring with a submission deadline several months before the test. Candidates schedule specific appointments with Pearson VUE after application approval. Exact 2026 dates should be confirmed on the ABPS examinations page.

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/fail result depends on performance relative to the fixed cut-score, not on other candidates. Score reports include domain-level feedback. Candidates must pass Written before becoming eligible for the Oral Examination.

What are the highest-yield topics?

Highest-yield topics include Mathes-Nahai flap classification with archetypal examples, perforator flap anatomy (DIEP, ALT, TAP, SGAP), cleft lip (Millard) and cleft palate (Furlow), craniofacial syndrome genes (Crouzon/Apert FGFR2, Treacher Collins TCOF1, Saethre-Chotzen TWIST1), craniosynostosis patterns, Parkland formula for burn resuscitation, BIA-ALCL (CD30+ with textured implants), Dupuytren management, flexor tendon zone II repair, Gustilo-Anderson open fractures, melanoma AJCC 8 margins and SLNB thresholds, and ISSVA vascular anomalies (GLUT1+ IH vs NICH/RICH).

How should I study for this exam?

Use a structured 12-18 month plan layered on residency. Map to the ABPS content outline: begin with wound healing and flap biology, then head and neck/craniofacial, breast, hand, microsurgery, burns, aesthetics, trunk/lower extremity, oncology, pediatric plastic, and ethics/safety. Integrate textbooks (Neligan, Thorne's Grabb and Smith's, Mathes-Nahai), In-Service exam questions, and high-volume MCQ practice. Complete 2-3 full-length timed mock exams. Drill flap anatomy, surgical techniques, and clinical photograph recognition.