Perforator Vessels of the Upper Chest: New Evidence from an Anatomic Study

Introduction: Vascularized tissue transfers based on perforator vessels have been proven to be reliable and versatile reconstructive procedures. In upper chest, such surgical procedures provide efficient post tumor extirpation or trauma defect reconstruction as well as improved aesthetic and quality of life outcomes. In this study the anatomic characteristics of the perforator vessels in the upper half of the breast are presented and analyzed. Methods: The dissection of 15 female adult fresh-frozen cadavers was performed. Perforators found during the deep subcutaneous/suprafascial dissection were marked, preserved and traced down to their origin at the intraand submuscular level. All perforator vascular pedicles (arteries and veins) greater than 0.4 mm were preserved and marked. All measurements were taken in millimeters using a micrometer. Results: The diameter of the dominant internal mammary artery perforator was 0.8 mm to 1.9 mm, and of the accompanying vein, 1.2 mm to 2.8 mm. Average sizes of lateral thoracic artery perforators was 1.40 mm ± 0.25 mm one main thoracoacromial artery perforator was usually identified in most subjects. Conclusion: The identification of upper chest perforator vessels and the confirmation of their anatomic characteristics through comparative analysis with existing literature have a fundamental comprehensive role leading to efficient surgical planning.