FCPS Part 2 Plastic Surgery Breast Surgery MCQs: High-Yield Practice Questions

Breast Surgery is a 184-question subject in HighYield's FCPS Part 2 Plastic Surgery question bank — one of the larger subspecialty blocks alongside Hand and Upper Extremity and Aesthetic Surgery — and it hasn't had a dedicated practice post until now. Below is a sample spanning reconstruction, reduction, and gynecomastia.

Breast Reconstruction

1. Which flap is considered a gold-standard option for autologous breast reconstruction because it spares the rectus abdominis muscle entirely?

• A) Pedicled TRAM flap
• B) DIEP (deep inferior epigastric perforator) flap ✅
• C) Latissimus dorsi flap
• D) Free TRAM flap

2. The thoracodorsal artery, the dominant blood supply used for latissimus dorsi flap breast reconstruction, is a branch of which vessel?

• A) Internal mammary artery
• B) Subscapular artery ✅
• C) Lateral thoracic artery
• D) Posterior intercostal artery

3. Compared with delayed reconstruction, immediate breast reconstruction at the time of mastectomy mainly offers which advantage?

• A) Eliminates the risk of capsular contracture
• B) Fewer total procedures and a better aesthetic result from the preserved skin envelope ✅
• C) Removes the need for adjuvant radiotherapy
• D) Avoids any risk of flap or implant infection

Capsular Contracture and Implants

4. Progressive firmness and distortion of a breast implant caused by scar tissue contracting around it is graded using which classification?

• A) Garden classification
• B) Baker classification ✅
• C) Gustilo classification
• D) Tanner classification

5. Textured breast implants, compared with smooth implants, are associated with a lower reported rate of capsular contracture but also a recognised association with which rare condition?

• A) Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) ✅
• B) Ductal carcinoma in situ
• C) Fibroadenoma
• D) Paget disease of the breast

Reduction Mammaplasty

6. Free nipple grafting during reduction mammaplasty is generally reserved for which scenario?

• A) Mild ptosis needing minimal tissue removal
• B) Gigantomastia with a very long nipple-to-notch distance, where pedicle viability is a concern ✅
• C) Routine augmentation-mastopexy
• D) Unilateral reconstruction only

Gynecomastia

7. Surgery for pubertal gynecomastia is typically deferred unless which feature is present, since most physiologic cases resolve spontaneously?

• A) Any palpable glandular tissue at puberty
• B) Persistence beyond roughly two years, or significant psychosocial distress ✅
• C) Unilateral tenderness alone
• D) A single episode of gynecomastia at any age

8. In true gynecomastia, the palpable firm tissue beneath the nipple-areola complex is composed primarily of:

• A) Adipose tissue alone
• B) Proliferated glandular (ductal and stromal) breast tissue ✅
• C) Fibrous scar tissue only
• D) Skin and subcutaneous tissue only

Why Breast Surgery Deserves Dedicated Revision

• Flap anatomy (DIEP vs TRAM vs latissimus dorsi) is tested repeatedly because the vascular pedicle determines both viability and donor-site morbidity.
• Implant-related complications (capsular contracture grading, BIA-ALCL) are a recurring theme across both the written paper and viva.
• Know which reduction pedicle or free-graft technique applies to which breast size and ptosis grade — examiners often test the decision point, not just the technique name.

HighYield's FCPS Part 2 Plastic Surgery question bank covers Breast Surgery alongside Hand and Upper Extremity, Aesthetic Surgery, Burns and Reconstruction, and every other subspecialty tested in the exam, with every question explained. For the complete picture of the exam itself, see our FCPS Part 2 application guide. Try the first questions free, no sign-in required.