The course of the intercostobrachial nerve in the axillary region and as it is related to transaxillary breast augmentation.
OBJECTIVE
The aim of this study was to precisely determine the course of the intercostobrachial nerve (ICBN) in the axillary region and as it is related to bony landmarks, and all of this might be of use for transaxillary breast augmentation.


METHODS
Thirty hemithoraxes of 15 fresh cadavers of Korean adults were dissected. After removal of the skin, the ICBN from its origin was identified. The point of emergence (EP) and the branching point (BP) were marked on translucent paper.


RESULTS
The ICBN appeared at the second intercostal space approximately (mean ± SD; 33.4 ± 12.7) mm lateral to the midclavicular line and 9.8 ± 6.4 mm medial to the lateral border of the pectoralis minor (P minor) muscle. The mean (SD) distance from the lower border of the second rib to the EP was 5.2 ± 2.0 mm. The mean ± SD distance from the upper border of the third rib to the EP was 12.7 ± 3.3 mm. It traveled inferolaterally (mean ± SD) 15.1 ± 10.4 degrees from the horizontal plane) 39.4 ± 19.2 mm to reach to the BP. The BP was located at the second intercostal space approximately (mean ± SD) 59.4 ± 21.2 mm lateral to the midclavicular line and 28.5 ± 18.2 mm lateral to the lateral border of the P minor muscle. The mean ± SD distance from the lower border of the second rib to the BP was 11.3 ± 5.4 mm. The mean ± SD distance from the upper border of the third rib to the BP was 6.3 ± 7.1 mm. At the BP, the ICBN gave off a medial brachial cutaneous nerve, and this coursed superolaterally [mean (mean ± SD, 50.7 ± 15.1 degrees from the horizontal plane) toward the medial surface of the upper arm. The mean ± SD depth of the ICBN from the superficial surface of the pectoralis major and P minor was 22.7 ± 5.7 mm and 15.0 ± 5.2 mm, respectively.


CONCLUSIONS
When performing mammary augmentation, care should be taken not to dissect the undersurface of the P minor at the second intercostal space to avoid injury to the ICBN.
From the *Department of Plastic Surgery and †Center for Advanced Medical Education by BK21 project, Inha University School of Medicine, Incheon, Korea; and ‡Department of Anatomy and § Institute for Applied Anatomy, Catholic University of Korea, Seoul, South Korea.
Kun
K
Hwang
Fan
F
Huan
Se Won
SW
Hwang
Sang Hyun
SH
Kim
Seung Ho
SH
Han
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000294:innervation*; D001917:Brachial Plexus / Q000033:anatomy & histology*; D001940:Breast / Q000294:innervation*; D018427:Breast Implants; D005260:Female; D006801:Humans; D007367:Intercostal Nerves / Q000033:anatomy & histology*; D008297:Male; D016462:Mammaplasty / Q000379:methods*