The superficial venous drainage of the breast: a clinical study and implications for breast reduction surgery.

[BACKGROUND] An understanding of the vascular anatomy of the breast is paramount in breast reduction surgery in order to minimize vascular complications. While most vascular compromise in breast reduction is largely venous in nature, the venous anatomy of the breast has not been sufficiently explored in the literature, particularly the inferior pole of the breast. Developments in infrared photography have enabled the use of this noninvasive technique to evaluate the venous architecture of the breast.

[METHODS] 32 voluntary participants (26 female, 6 male) underwent infrared photography of the superficial veins of the breast. Using a modified technique, the venous architecture of the breast, with an emphasis on the inferior pole veins, was evaluated.

[RESULTS] Infrared photography was able to clearly demonstrate the superficial veins of the breast in all cases. The subareolar plexus and pattern of venous radiation from this plexus were evident, with a predominant pattern of superomedial and inferior pole drainage seen. Although the dominant drainage route was via the third and fourth intercostal spaces, two patterns of drainage were noted: superomedial drainage to the 2nd and 3rd intercostal spaces (29 out of 29 cases) and lower pole drainage to the 4th and/or 5th intercostal space (27 of 29 patients - 93.1%).

[CONCLUSION] The venous architecture of the breast is demonstrated clearly with the techniques described, enabling the improved planning of breast reduction pedicles. Preservation of the superficial venous drainage as well as the arterial supply can help to mini mize the incidence of vascular complications.