New Possible Surgical Approaches for the Submammary Adipofascial Flap Based on Its Arterial Supply

Figure 8

(a) A photograph of left breast (Br) showing the pectoralis major muscle (PM) cut and reflected to show the axillary artery (AA) and axillary vein (AV) giving the thoracodorsal vessels (TD) that run downwards and give a branch (arrow) to the left breast and the circumflex scapular vessels (arrow head) and terminate as perforator (P) to SMAF. This perforator divides into medial (A) and lateral (B) branches. The intercostobrachial nerve (IB) is noted. (b) A photograph of the right breast (Br) showing the pectoralis major muscle (PM) cut and reflected and the pectoralis minor muscle (Pm) deep to it. The axillary artery (AA) and axillary vein (AV) can be seen. They give the lateral thoracic vessels (LT) which supply the breast itself and give perforator (P1) to SMAF. They also give the thoracodorsal vessels (TD) which give perforator (P2) that communicates through branches (arrows) with P1 and supply SMAF. The distal part of P2 gives 2 capillary perforators, upper (A) and lower (B). Serratus anterior muscle (SA) can be seen. The intercostobrachial nerve (IB) is noted.

(a)

(b)