FASCIAL SUPPORTING NETWORK OF THE BREAST
Goal of the study: to refine the surgical anatomy of the fascial supporting network the breast as a basis for preoperative planning of aesthetic and reconstructive interventions. Literature data of Russian and international authors, which include descriptions of different versions of fascial anatomy of the breast, as well as the importance of its assessment for preoperative planning of the tactics of surgical intervention and prognosis of possible postoperative complications, has been analyzed. Anatomic justification of the presented data by the method of continuous sampling from scientific databases has been carried out. The information from available anatomic and surgical textbooks has been analyzed without additional conditions. According to the analyzed literature data, most authors separate the following fascial formations: the fascia of Scarpa forms the breast cap and takes part in formation of three-dimensional subcutaneous scaffold. The Wuringer membrane plays the leading role in blood supply of the nipple-areola system (NAS). The development of this membrane varies in different patients depending on the following factors: age, breast size, weight, obesity, and activity of glandular tissue. For the recent years, the authors separate a bilaminar vertical fibrous septum, which divides the bottom part of the breast into the medial and lateral sections. Intercostal perforator veins, which take part in the NAS blood supply, lie along this septum. No unified vision of formation of the fascial structure of submammary groove was formulated based on the performed analysis. Aesthetic and plastic interventions at the breast pathology are now impossible without knowledge of the supporting fascial-fibrous structure of the breast and peculiarities of its blood supply. Underestimation of anatomicmorphological peculiarities of the structure by a surgeon in the planning of reconstruction, as well as absence of personal approach, leads to appearance of both immediate and long-term complications requiring repeated inter- № 2 (65) июнь’ 2018 Вопросы реконструктивной и пластической хирургии Клиническая анатомия 35 ventions. The existence of a lot of conflicting theories ofthe structure and fascial anatomy of the breast requires further investigations in this field in order to improve immediate and long-term results.
Keywords
молочная железа,
пластика молочной железы,
фасция,
хирургическая анатомия молочных желез,
фасциальная структура,
мембрана Wuringer,
вертикальная септа,
breast,
breast plastic,
fascia,
surgical anatomy of breast,
fascial structure,
Wuringer membrane,
vertical septumAuthors
| Egorov Yu.S. | Russian Medical Academy of Postgraduate Education | |
| Kuznetsova L.V. | Russian Medical Academy of Postgraduate Education | dr.lidiiakuznetsova@gmail.com |
| Dzotsoev A.K. | Medline Service Ltd | |
Всего: 3
References
Gabka C.J., Bohmert H. Космотическая и пластическая хирургия молочной железы. В кн.: Пластическая и реконструктивная хирургия молочной железы: пер. с англ. 2010:28-29. [Gabka K.J., Bomert H. Cosmotic and plastic surgery of the mammary gland. In: Plastic and reconstructive surgery of breast iron. Translation from English. 2010:28-29] (In Russ.).
Eisenmann-Klein M., Neuhann-Lorenz C. Вертикальная мастопексия. Innovations in Plastic and Aesthetic Surgery. 2011:333-334. [Eisenmann-Klein M., Neuhann-Lorentz S. Vertical Mastopexy. Innovations in Plastic and Aesthetic Surgery. 2011:333-334].
Achuh F., Cericatto R., Bittelbrunn A.C., Cavalheiro J.A., Biazus J.V., Inframammary fold reconstruction. In: Oncoplastic and Reconstructive Breast Surgery. Springer; 2013:325-330.
Scarpa A. Sull’ernie: Memorie Anatomico-Chirurgiche. Milano, d. Reale Stamperia; 1809.
Cooper A.P. Of the internal parts of the breast or mammary gland. In: Cooper A. editor. On the anatomy of the breast. London: Longman, Orme, Green, Brown, and Longmans. 1840:48-58.
Hammond D.C. Applied anatomy. In: Atlas of Aesthetic Breast Surgery. 1st ed. Elsevier; 2009:1-10.
Bayati S., Seckel B.R. Inframammary crease ligament. Plastic and Reconstractive Surgery. 1995(1 of 295 (3)):501-508.
Taylor G.I., Palmer J.H. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987:113-41.
Саруханов Г.М., Боровиков А.М. Фасциальная система молочной железы. Новый взгляд. Ч. I. Анатомия и хирургическое значение складки молочной железы. Пластическая хирургия и косметология. 2011;(4):587-596
Maillard G.F., Garey L.J. An improved technique for immediate retropectoral reconstruction after subcutaneous mastectomy. Plast Reconstr Surg. 1987;80:396-408.
Nava M., Quattrone P., Riggio E. Focus on the breast fascial system: a new approach for inframammary fold reconstruction. Plast Reconstr Surg. 1998;102:1034-45.
Riggio E., Quatron P., Nava M. Anatomic study of the superficial fascial breast system: inframammary folded unit. Eur J Plast Surg. 2000:310-5.
Matousek S.A., Corlett R.J., Ashton M.W. Understanding of the fascial auxiliary breast network: key ligament structures in the breast and the proposed nomenclature system. Plast Reconstr Surg. 2014:273-81.
Pennisi V.R. Making a definite inframammary fold under a reconstructed breast. Plastic Reconstructive Surgery. 1977;60(4):523-525.
Santos D.C., Cardoso A., Martins J.M. et al. Suspensory ligament of the mammary gland: a case report. Aesthetic Plast Surg. 2016;40:98-101.
Würinger E., Mader N., Posch E., Holle J. Nerve and vessel supplying ligamentous suspension of the mammary gland. Plast Reconstr Surg. 1998;101:1486-1493.
Würinger E., Tschabitscher M. New aspects of the topographical anatomy of the mammary gland regarding its neurovascular supply along a regular ligamentous suspension. Eur J Morphol. 2002;40:181-189.
Егоров Ю.С., Дзотцоев А.К. Кровоснабжение сосково-ареолярного комплекса. Опухоли женской репродуктивной системы. 2017;13:43-45
Palmer J.H., Taylor G.I. The vascular territories of the anterior chest wall. Brifish Journal of Plastic Surgery. 1986;39:287-299.
Mostafa Abdel Rahman Awad, Mahmoud Magdi Sherif1, Eaman Yahya Sadek, Hesham Aly Helal, Wafaa Raafat Abdel Hamid. A New Septum in the Female Breast. Arch Plast Surg. 2017;44:101-108.
