The literature on surgical reconstruction of the breast is surprisingly lacking in adequate descriptions of the blood supply. Many of the procedures in common use appear to have been developed without regard for the preservation of vascularization.1 Still others are based on a concept of the blood supply which more recent studies prove to be erroneous. Yet preservation of the arterial blood supply is one of the most essential factors in the success of mammaplasty.
The breast is a highly vascular organ. Its surgical reconstruction requires wide undermining of skin flaps, excision of large masses of fat and glandular tissue, with rotation and fixation of the remaining parts. In the course of the operation a number of vessels are likely to become severed or twisted, with resultant interference with vascularization. When there is accurate knowledge of the vascular anatomy this contingency can be avoided.2 The following factors are