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

Figure 9

(a) A photograph of the left breast (Br) showing the axillary artery (AA) giving the long thoracic artery (LT) which gives perforator (P1) to SMAF and the thoracodorsal artery (TD) which gives muscular branch (M) to latissimus dorsi (LD) and 3 perforators (P2, P3, and P4) to SMAF. A communicating vessel between P1 and P2 is pointed by arrow. P1 gives 2 capillary perforators: upper (A) and lower (B) in SMAF. Thoracoacromial artery (TA) and intercostobrachial nerve (IB) are noted. (b) A photograph of the right breast (Br) showing the axillary artery (AA) giving thoracoacromial artery (TA), long thoracic artery (LT), and thoracodorsal artery (TD). LT gives perforator (P1). TD gives muscular branch (M) to latissimus dorsi (LD) and perforator (P2). P2 divides into medial branch (A) and lateral branch (B). P1 and (A) join and supply SMAF. AA gives a direct perforator (P3) to SMAF. P3 divides into medial branch (C) and lateral branch (D). A communicating vessel between P2 and P3 is pointed by arrow. The intercostobrachial nerve (IB) is noted.

(a)

(b)