Suspensory Ligament of the Mammary Gland: A Case Report

Dm, Santos; Cardoso, Augusta; Martins, João; Barroso, Maria da Luz; Costa, Horácio

doi:10.1007/s00266-015-0589-2

Cited by 6 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Native breast tissue is a highly heterogeneous structure composed of a high degree of adipose tissue, as well as glandular tissue and the superficial fibrous fascia. , This fibrous structure, which forms a 3D network in the breast often denoted as suspensory ligaments or Cooper’s ligaments, develops both as thicker bundles to suspend the breast and as fine, hair-like fibers that infiltrate through the adipose tissue region. This fibrous part of the tissue provides structural support to the soft adipose tissue.…”

Section: Resultsmentioning

confidence: 99%

“…We hypothesize that to have a role as an internal bra, a scaffold should not match the adipose tissue’s mechanical properties in the early stages of regeneration but rather those of the fibrous fascia that shield the cells from external deformations. Aside from adipose tissue, breast tissue is heterogeneous and consists of glands and a fibrous fascia known as Cooper’s ligament, or suspensory ligaments penetrating the tissue. − The fibrous fascia and collagen fibers are unevenly distributed, and their distribution varies depending on the patient, age, and from where the sample is isolated. This heterogeneous structure is the reason why mechanical properties of breast tissue differ significantly from those of pure adipose tissue and renders their assessment difficult. − Over time, scaffold degradation and the consequent decrease in mechanical properties will stimulate native tissue growth and scaffold replacement.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pliable, Scalable, and Degradable Scaffolds with Varying Spatial Stiffness and Tunable Compressive Modulus Produced by Adopting a Modular Design Strategy at the Macrolevel

et al. 2021

View full text Add to dashboard Cite

Clinical results obtained when degradable polymer-based medical devices are used in breast reconstruction following mastectomy are promising. However, it remains challenging to develop a large scaffold structure capable of providing both sufficient external mechanical support and an internal cell-like environment to support breast tissue regeneration. We propose an internal-bra-like prototype to solve both challenges. The design combines a 3D-printed scaffold with knitted meshes and electrospun nanofibers and has properties suitable for both breast tissue regeneration and support of a silicone implant. Finite element analysis (FEA) was used to predict the macroscopic and microscopic stiffnesses of the proposed structure. The simulations show that introduction of the mesh leads to a macroscopic scaffold stiffness similar to the stiffness of breast tissue, and mechanical testing confirms that the introduction of more layers of mesh in the modular design results in a lower elastic modulus. The compressive modulus of the scaffold can be tailored within a range from hundreds of kPa to tens of kPa. Biaxial tensile testing reveals stiffening with increasing strain and indicates that rapid strain-induced softening occurs only within the first loading cycle. In addition, the microscopic local stiffness obtained from FEA simulations indicates that cells experience significant heterogeneous mechanical stimuli at different places in the scaffold and that the local mechanical stimulus generated by the strand surface is controlled by the elastic modulus of the polymer, rather than by the scaffold architecture. From in vitro experiments, it was observed that the addition of knitted mesh and an electrospun nanofiber layer to the scaffold significantly increased cell seeding efficiency, cell attachment, and proliferation compared to the 3D-printed scaffold alone. In summary, our results suggest that the proposed design strategy is promising for soft tissue engineering of scaffolds to assist breast reconstruction and regeneration.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pliable, Scalable, and Degradable Scaffolds with Varying Spatial Stiffness and Tunable Compressive Modulus Produced by Adopting a Modular Design Strategy at the Macrolevel

et al. 2021

View full text Add to dashboard Cite

show abstract

“…To date, the ligamentous system of the breast comprises deep and superficial components. The deep one includes horizontal, medial vertical, lateral vertical, cranial and posterior ligaments connecting the breast to the chest wall, while the superficial component includes horizontal, vertical medial and vertical lateral ligaments attached to the dermis and defining the breast [14].…”

Section: Discussionmentioning

confidence: 99%

A New Septum in the Female Breast

et al. 2017

View full text Add to dashboard Cite

BackgroundUnderstanding the female breast fascial system is of paramount importance in breast surgery. Little was written about breast ligaments. Most articles refer to Cooper's work without further anatomical studies. Lately, a horizontal septum has been described conveying nerves and vessels to the nipple areola complex.MethodsDuring the surgical dissection of the lower part of the breast, in supero-medial technique for breast reduction operations, a fascial septum between the lower two quadrants was detected. This fibrous septum was studied through anatomic dissection of breast tissues during routine breast reshaping procedures that was done on 30 female patients. Magnetic resonance imaging (MRI) was performed preoperatively in all cases and correlated with the intraoperative findings. In the other five cases, outside the clinical study, the imaging was done during routine investigation for breast swellings.ResultsA vertical septum was identified in the lower part of the breast, lying at the breast meridian between the two lower quadrants. It is a tough bi-laminated structure that extends from the middle of the infra-mammary crease caudally to nipple-areola complex cranially and from the pectoral fascia posteriorly to the overlying skin anteriorly. This was proved by MRI findings.ConclusionsThis study describes a new inferior vertical septum which separates the lower half of the breast into two definite anatomical compartments: medial and lateral.

show abstract

“…Variations and anomalies of Cooper ligaments have been described. A recent case report by Santos et al 4 described intraoperative observations of a condensation of Cooper ligaments forming what they referred to as a suspensory ligament of the mammary gland that suspended the most cranial aspect of the breast to the clavicular periosteum (Fig. 3).…”

Section: Primary Focusmentioning

confidence: 99%

Anatomy of the Breast Fascial System: A Systematic Review of the Literature

Duncan

Youha

Joukhadar

et al. 2021

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: Understanding the anatomy of the fascial and ligamentous structures of the breast is important in both aesthetic and reconstructive breast surgery. Several structures have been identified that play a significant role in the aesthetic qualities and support of the breast warranting consideration in the context of breast reconstruction. Methods: The authors performed a systematic review of anatomical, clinical, histologic, and radiologic studies that have described, characterized, and named these structures. The authors have summarized and critically appraised prior research to clarify and define the key fascial structures of the breast, their anatomical function, and their clinical significance in aesthetic and reconstructive breast surgery. Results: Through their review, six distinct breast fascial structures were encountered consistently in the literature. The authors have organized them into intraglandular and extraglandular structures and have reviewed their significance in the context of reconstructive breast surgery. Conclusions: The primary fascial structures of the breast are important anatomical landmarks with numerous clinical applications. Cooper ligaments divide the breast parenchyma. The superficial and deep layers of the superficial fascia encase the breast in a "pocket," condensing into one thickened layer of fascia along the peripheral breast footprint. The inframammary fold supports and defines the inferior pole. The horizontal septum is a reliable neurovascular landmark. The vertical septum is a newly discovered fascial structure. There are certainly clinical implications that have yet to be described because of the relatively limited and disputed information on the fascia of the female breast and, ultimately, more research is warranted.

show abstract

Suspensory Ligament of the Mammary Gland: A Case Report

Abstract: This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Cited by 6 publications

References 8 publications

Pliable, Scalable, and Degradable Scaffolds with Varying Spatial Stiffness and Tunable Compressive Modulus Produced by Adopting a Modular Design Strategy at the Macrolevel

Pliable, Scalable, and Degradable Scaffolds with Varying Spatial Stiffness and Tunable Compressive Modulus Produced by Adopting a Modular Design Strategy at the Macrolevel

A New Septum in the Female Breast

Anatomy of the Breast Fascial System: A Systematic Review of the Literature

Contact Info

Product

Resources

About