[The neuro-vascular anatomical study of breast and it's signification in reduction mammaplasty].
OBJECTIVE
to investigate the pattern of the blood supply and the nerve distribution of breast, in order to find a way for short-scar reduction mammaplasty.


METHODS
Twelve adult women cadavers were investigated for the vascularture of the anterior thorax and the nerve distribution of the breasts by using the blood vessel casting, specimen transparency technique and the autopsy. Based on the anatomical study, a modified double-circle reduction mammaplasty technique was designed to treat 28 patients with hypertrophical breasts.


RESULTS
There existed two- or three-layers vasculature in the anterior thorax. The extensive vertical vascular anastomoses were found among the three layers. The cutaneous perforators, penetrated out of the pectoralis major muscle, were formed a dense vessel network in the retromammary space. The vertical vessels thereafter emerged from the network, passed through gland and linked to the subcutaneous vessels. These vertical vessels were smaller and denser above the fourth intercostal space, but they were larger and sparser below the fourth intercostal space. The innervation of the nipple-areola mainly came from the lateral deep branches of the 4th intercostal nerve. It appeared S-shape running into the dropped breasts. The 28 patients were successfully treated with the modified technique, except one case with the loss of the nipple-areola sense.


CONCLUSIONS
The modified double-circle reduction mammaplasty could maximally fulfill the blood supply to the remained gland and the innervations to the nipple-areola, by keeping the advantages of the traditional technique such as invisible scar, good projection and the long lasting results. It could also be a safe and reliable technique.
Sun
Jia-Ming
JM
Plastic Surgery Hospital of China Academy of Medical Science, Beijing 100041, China.
Qiao
Qun
Q
Zhao
Ru
R
Liu
Zhi-Fei
ZF
Yan
Ying-Jun
YJ
Sun
Bao-Dong
BD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001808:Blood Vessels / Q000033:anatomy & histology*; D001940:Breast / Q000098:blood supply / Q000294:innervation / Q000601:surgery; D002102:Cadaver; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008953:Models, Anatomic; D009420:Nervous System / Q000033:anatomy & histology*; D016896:Treatment Outcome