Abstract:Objective
To study the arterial blood supply of nippleareola and provide the anatomical basis for avoiding nippleareola necrosis in breast operation. Methods The vascular structure of nippleareola of 26 female breasts in 13 cadavers were studied.
Results The nippleareola mainly accepted arterial blood supply from branches of the lateral thoracic artery and the internal thoracic artery. The 2nd~4th intercostal perforating branches of the internal thoracic artery and branches of the lateral thoracic artery reach the base of nippleareola from a superior,medial and upper lateral direction by passing between lobules of mammary gland, then ascend between the lacteal ducts to supply the nippleareola; the perforators of the lateral thoracic artery and the superticial breast perforators of internal thoracic artery, formed extensive anastomoses subcutaneously, and particulatly under areola formed arterial rete, from which branches were given out to nippleareola. The intercostal perforators and thoracoacromial perforators did not supply the nippleareola.
Conclusions When nipplesparing mastectomy is performed, in order to avoid nippleareola necrosis,it is necessary to protect the arterial rete under the areola, and thus, the thickness of areolar skin flap should not be less than 0.5cm; to ensure the blood supply of nippleareola from the internal thoracic artery and the lateral thoracic artery in breast reduction, the superiormedial or superiorlateral breast pedicle should be used and the thickness of preserved posterior breast should not be less than 1.5cm.