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Nipple-Areolar Complex Reconstruction pp 55–65Cite as

Blood Supply to the Nipple–Areola Complex and Intraoperative Imaging of Nipple Perfusion Patterns

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Abstract

Ischemic complications involving the nipple–areola complex (NAC) occur in 3–37% of cases of nipple-sparing mastectomies (NSM). Loss of the NAC to ischemic necrosis postoperatively is very distressing to patients who chose a NSM and expect to keep their nipple. Understanding the anatomy of the blood supply to the NAC and ensuring that the preserved skin envelope provides adequate blood supply to the NAC in NSM is key to decreasing ischemic complications. In this chapter, we review the blood supply to the breast and to the NAC, the implications for pedicled flap design, and methods of intraoperative imaging of breast perfusion, including fluorescein angiography, infrared imaging, Doppler sonography, tissue spectrophotometry, and near-infrared spectroscopy. This chapter specifically focuses on indocyanine green angiography, which has rapidly become part of nipple-sparing mastectomy operating room equipment.

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Authors and Affiliations

  1. Université de Montréal, CP 6128, Succ. Centre-ville, Pavillon Roger-Gaudry - Local S-716, 2900 Edouard Montpetit Blvd, Montréal, QC, H3C 3J7, Canada

    Mingsha Zhou M.D.

  2. Stanford Womens Cancer Center, 900 Blake Wilbur, Stanford, CA, 94305, USA

    Irene Wapnir

  3. Department of Plastic Surgery, Stanford University, 1000 Welch Road, Suite 100, MC 5348, Palo Alto, CA, 94304, USA

    David Kahn

Authors
  1. Mingsha Zhou M.D.
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  2. Irene Wapnir
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  3. David Kahn
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Corresponding authors

Correspondence to Mingsha Zhou M.D. , Irene Wapnir or David Kahn .

Editor information

Editors and Affiliations

  1. Private Practice, Tustin, California, USA

    Melvin A. Shiffman

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© 2018 Springer International Publishing AG

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Zhou, M., Wapnir, I., Kahn, D. (2018). Blood Supply to the Nipple–Areola Complex and Intraoperative Imaging of Nipple Perfusion Patterns. In: Shiffman, M. (eds) Nipple-Areolar Complex Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-319-60925-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-60925-6_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60924-9

  • Online ISBN: 978-3-319-60925-6

  • eBook Packages: MedicineMedicine (R0)

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