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The Anatomy and Variations of the Internal Thoracic (Internal Mammary) Artery and Implications in Autologous Breast Reconstruction

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Breast Reconstruction

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Abstract

Internal mammary vessels travel parallel to the lateral border of the sternum. The vein divides in two usually at the level of the second rib. Main perforators arise in second and first intercostal space, suitable in some cases for anastomosis. Microsurgical anastomosis can be performed to the proximal or distal end of the internal mammary artery, and the same, due to the lack of valves, can be done in the internal mammary vein. This is especially useful in supercharged flaps, or when two flaps are needed for unilateral breast reconstruction. Internal mammary artery (IMA) and internal mammary vein (IMV) are the recipient vessels of choice in autologous breast reconstruction. The anatomical variability is low, being a safe and constant receptor pedicle. The approach of the vessels in the second intercostal space prevents removal of the costal cartilage, saving time and associated morbidity.

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Authors and Affiliations

  1. Plastic Surgery Department, Hospital Universitario de Guadalajara, c/Donantes de Sangre s/n, Guadalajara, 19002, Spain

    Emilio García-Tutor M.D., Ph.D

  2. Department of Surgery, Universidad de Alcalá, Plaza de San Diego s/n., Alcalá de Henares, Madrid, 28801, Spain

    Emilio García-Tutor M.D., Ph.D

  3. Plastic Surgery Department, MD Anderson Cancer Center, c/ Arturo Soria 270, Madrid, 28033, Spain

    Emilio García-Tutor M.D., Ph.D

  4. Radiology Department, Vascular and Interventional Radiology Unit, Hospital Universitario Fundación Jiménez Díaz, Av. Reyes Católicos 2, Madrid, 28040, Spain

    Alberto Alonso M.D., Ph.D

  5. Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, 246 Clayton Road, Clayton, VIC, 3168, Australia

    Warren Rozen MBBS, BMedSc, M.D., Ph.D.

  6. Monash University Plastic and Reconstructive Surgery Unit (Peninsula Clinical School), Peninsula Health, 2 Hastings Road, Frankston, VIC, 3199, Australia

    Warren Rozen MBBS, BMedSc, M.D., Ph.D.

  7. Department of Surgery, School of Medicine and Dentistry, James Cook University Clinical School, Level 1, Townsville Hospital, Townsville, QLD, Australia

    Warren Rozen MBBS, BMedSc, M.D., Ph.D.

Authors
  1. Emilio García-Tutor M.D., Ph.D
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  2. Alberto Alonso M.D., Ph.D
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  3. Warren Rozen MBBS, BMedSc, M.D., Ph.D.
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Corresponding author

Correspondence to Emilio García-Tutor M.D., Ph.D .

Editor information

Editors and Affiliations

  1. Tustin, California, USA

    Melvin A. Shiffman

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García-Tutor, E., Alonso, A., Rozen, W. (2016). The Anatomy and Variations of the Internal Thoracic (Internal Mammary) Artery and Implications in Autologous Breast Reconstruction. In: Shiffman, M. (eds) Breast Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-18726-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-18726-6_7

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18725-9

  • Online ISBN: 978-3-319-18726-6

  • eBook Packages: MedicineMedicine (R0)

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