Vascular Anatomy of the Breast and Nipple-Areola Complex

  • Petrus van DeventerEmail author


The blood supply to the breast is the result of the embryonic development, and therefore a basic horizontal segmental pattern similar to that of the thoracic wall exists. The main sources are the internal thoracic, lateral thoracic, anterior intercostal and acromio-thoracic arteries. The branches from the main sources have fixed areas where they originate on the thoracic wall, but the further distribution and patterns formed to supply the nipple-areola complex vary considerably. In some instances one or more of the main sources are underdeveloped or absent. The result of which is the change in the basic horizontal pattern in a variety of different patterns. The most reliable source is the upper four perforating branches of the internal thoracic artery.


  1. 1.
    Cooper AP. Volume 1: On the anatomy of the breast. Pascal Brooke Bland: Longman, Orme, Green, Brown & Longmans, London, Harrison & Co printers; 1840. pp. 32–4, 74–8.Google Scholar
  2. 2.
    Manchot C. Die Haut Arterien des Menslichen Korpers. Leipzig: Vogel F.C.W. Erstes Capitel; 1899. p. 8–11.Google Scholar
  3. 3.
    Würinger E, Mader N, Posch E, Holle J. Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconstr Surg. 1998;101:1486–93.CrossRefPubMedGoogle Scholar
  4. 4.
    Van Deventer PV. The blood supply to the nipple-areola complex of the human mammary gland. Aesthet Plast Surg. 2004;28:393–8.CrossRefGoogle Scholar
  5. 5.
    Marcus GH. Unter suchungen uber die arterielle blutversorgung der mamilla. Arch Klin Chir. 1934;179:361–9.Google Scholar
  6. 6.
    O’Dey DM, Pallua N, Perscher A. Vascular reliability of nipple-areola complex bearing pedicles: an anatomical microdissection study. Plast Reconstr Surg. 2006;119:1167–77.CrossRefGoogle Scholar
  7. 7.
    Salmon M. Les artères de la glande mammaire. Ann Anat Pathol. 1939;16:477–500.Google Scholar
  8. 8.
    Nakajima H, Imanishi N, Aiso S. Arterial anatomy of the nipple-areola complex. Plast Reconstr Surg. 1995;96:843–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Anson BJ, Wright RR, Wolfer JH. Blood supply of the mammary gland. Surg Gynecol Obstet. 1939;69:468–73.Google Scholar
  10. 10.
    Le Roux CM, Birgitte JK, Wei-Ren P, Warren MR, Mark WA. Preserving the neurovascular supply in the Hall-Findlay superomedial pedicle breast reduction: an anatomical study. JPRAS. 2009;63:655–62.Google Scholar
  11. 11.
    Seitz IA, Nixon AT, Friedewald SM, Rimler JC, Schechter LS. "NACsomes": a new classification system of the blood supply to the nipple areola complex (NAC) based on diagnostic breast MRI exams. JPRAS. 2015;68(6):792–9.PubMedGoogle Scholar
  12. 12.
    Palmer JH, Taylor GI. The vascular territories of the anterior chest wall. Br J Plast Surg. 1986;39:287–99.CrossRefPubMedGoogle Scholar
  13. 13.
    Van Deventer PV, Page BJ, Graewe FR. The safety of pedicles in breast reduction and mastopexy procedures. Aesthet Plast Surg. 2008;32:307–12.CrossRefGoogle Scholar
  14. 14.
    Loukas M, du Plessis M, Owens DG, Kinsella CR Jr, Litchfield CR, Nacar A, Lu O, Tubbs RS. The lateral thoracic artery revisited. Surg Radiol Anat. 2014;36(6):543–9.PubMedGoogle Scholar
  15. 15.
    Van Deventer PV, Graewe FR. Enhancing pedicle safety in mastopexy and breast reduction procedures: the posteroinferomedial pedicle, retaining the medial vertical ligament of Würinger. Plast Reconstr Surg. 2010;126:786–93.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Division of Plastic and Reconstructive SurgeryUniversity of StellenboschTygerbergSouth Africa
  2. 2.Faculty of Health SciencesUniversity of StellenboschTygerbergSouth Africa

Personalised recommendations