A clinical anatomic study of internal mammary perforators as recipient vessels for breast reconstruction

In Soo Baek, Jae Pil You, Sung Mi Rhee, Gil Su Son, Deok Woo Kim, Eun Sang Dhong, Seung Ha Park, Eul Sik Yoon

    Research output: Contribution to journalArticlepeer-review

    8 Citations (Scopus)

    Abstract

    Background Partially resecting ribs of the recipient site to facilitate easy anastomosis of the internal mammary vessels to free flaps during breast reconstruction can cause chest wall pain or deformities. To avoid this, the intercostal perforating branches of the internal mammary vessels can be used for anastomosis. The purpose of this study was to investigate the location and size of the internal mammary perforator vessels based on clinical intraoperative fndings and to determine their reliability as recipient vessels for breast reconstruction with microsurgical free tissue transfer. Methods Twelve patients were preoperatively screened for the presence of internal mammary perforators using Doppler tracing. After modified radical mastectomy was performed by a general surgeon, the location and size of the internal mammary perforator vessels were microscopically investigated. The external diameter was examined using a vessel-measuring gauge from a mechanical coupling device, and the distance from the mid-sternal line to the perforator was also measured. Results The largest arterial perforator averaged 1.5 mm, and the largest venous perforator averaged 2.2 mm. Perforators emerging from the second intercostal space had the largest average external diameter; the second intercostal space also had the largest number of perforators arising from it. The average distance from the mid-sternal line to the perforator was 20.2 mm. Conclusions Internal mammary perforators presented consistent and reliable anatomy in this study. Based on these results, the internal mammary perforators appear to have a suitable diameter for microvascular anastomosis and should be considered as an alternative recipient vessel to the internal mammary vessel.

    Original languageEnglish
    Pages (from-to)761-765
    Number of pages5
    JournalArchives of Plastic Surgery
    Volume40
    Issue number6
    DOIs
    Publication statusPublished - 2013 Nov

    Keywords

    • Breast neoplasms
    • Free tissue flaps
    • Mammary arteries
    • Mastectomy

    ASJC Scopus subject areas

    • Surgery

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