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Computed Tomographic Angiography-Based Characterization of Source Blood Vessels for Nipple–Areola Complex Perfusion in Hypertrophic Breasts

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  • Breast Surgery
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Abstract

Background

Current knowledge about the blood supply of the nipple–areola complex (NAC) has largely been derived from studies on cadavers or persons with breasts of normal size. The aim of this study was to identify and classify the NAC blood supply by computed tomographic angiography (CTA) examination in female volunteers with breast hypertrophy.

Methods

CTA examination was performed on hypertrophic breasts of 23 female subjects. The main blood supplies were revealed through image data analyses. The dominant blood supply of the NAC and its vascular sources were identified and sorted. The detectable diameter threshold of blood vessels was set beyond 1.0 mm.

Results

A total of 61 dominant blood vessels were identified. The source arteries were traced as the internal thoracic artery (ITA, 50.8%), lateral thoracic artery (LTA, 27.8%), thoracoacromial artery (TA, 14.8%), brachial artery (BA, 3.3%), and axillary artery (AA, 3.3%), and the corresponding reproducibility of these source vessels was 31, 37, 9, 4.3, and 4.3%, in all breasts. The intercostal artery (IA) was not identified as a dominant NAC supplying vessel in any CTA scan image. Twenty-six breasts had only one dominant artery, whereas 17 breasts showed multiple dominant blood supplies. Three breasts showed no dominant blood vessels of the NAC, with diameters greater than the detectable threshold of 1.0 mm, and 52.2% of the breasts demonstrated anatomically symmetrical patterns of blood supply for the NAC.

Conclusions

The ITA, LTA, and TA are likely to be the main vessel sources, whereas the IA is unlikely to be the dominant vessel for NAC perfusion, on the basis of the studied breasts. An asymmetrical pattern of bilateral breast blood supply was demonstrated in a considerable portion of the females with breast hypertrophy in this study.

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Acknowledgement

None of the authors has a financial interest in any of the products or devices mentioned in this article. This study was supported by the National Natural Science Foundation of China (81471884, 81671932), Natural Science Basic Research Plan in Shaanxi Province (2015JM8444), and Science and Technology Project of Shaanxi Province (2014k11-02-03-12). The authors thank each of their colleagues at the Institute of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, for their full cooperation and support.

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    Authors and Affiliations

    1. Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, No. 15, Changle West Road, Xi’an, 710032, Shaanxi, China

      Hui Zheng, Yingjun Su, Lihong Qiu, Zhaoxiang Zhang, Jian Geng & Chenggang Yi

    2. Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, 710032, Shaanxi, China

      Minwen Zheng, Jian Li & E. Bei

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    1. Hui Zheng
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    Correspondence to Chenggang Yi.

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    Hui Zheng and Yingjun Su have contributed equally to this research and should be viewed as co-first authors.

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    Zheng, H., Su, Y., Zheng, M. et al. Computed Tomographic Angiography-Based Characterization of Source Blood Vessels for Nipple–Areola Complex Perfusion in Hypertrophic Breasts. Aesth Plast Surg 41, 524–530 (2017). https://doi.org/10.1007/s00266-017-0791-5

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    • DOI: https://doi.org/10.1007/s00266-017-0791-5

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