The anatomy of the pectoral nerves and its significance in breast augmentation, axillary dissection and pectoral muscle flaps

David, S.; Balaguer, Thierry; Baqué, Patrick; Peretti, F. De; Valla, Maxime; Lebreton, E.; Chignon-Sicard, Bérengère

doi:10.1016/j.bjps.2012.03.032

Cited by 24 publications

(17 citation statements)

References 23 publications

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“…More recently, accurate and more detailed studies have shown a three-nerve supply for PMM (22). Such description is also corroborated by the anatomical and functional classification of PMM itself, with three distinct parts: its clavicular portion, sternal and costal aspects.…”

Section: Anatomy Of Pectoral Nervesmentioning

confidence: 67%

Selective pectoralis major muscle denervation in breast reconstruction: a technical modification for more effective and cosmetic results

2017

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The use of pectoralis major muscle (PMM) in breast reconstruction has been a mainstay for decades. In recent years, although, a novel approach, the so-called subcutaneous or pre-pectoral breast reconstruction, has been introduced advocating the advantages of sparing the pectoralis muscle. Such advantages include more natural implant ptosis and appearance, significant reduction of capsular contracture and also avoidance of implant animation and animation deformities. These are all drawbacks that the use of muscles in implant coverage inevitably involves overtime. Nonetheless, there are clinical situations which definitely require the use of a muscle coverage either for surgical safety or for a better cosmetic outcome.In such cases a slight and simple modification of the standard technique can be adopted to prevent these drawbacks. While performing the muscular pocket two of the three main nerve trunks of the PMM can be severed, thus leaving innervated only the upper portion of the muscle. The remaining two thirds, basically the part covering a tissue expander (TE) or an implant, will therefore retain a status of a viable soft tissue without any muscular contraction. A significant atrophy will definitely ensue, but a sufficiently vascularized and floppy cushion will cover the prosthetic breast reconstruction device, protecting and masking it.

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Section: Anatomy Of Pectoral Nervesmentioning

confidence: 67%

Selective pectoralis major muscle denervation in breast reconstruction: a technical modification for more effective and cosmetic results

2017

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“…In another study of 15 fresh cadavers [3], they found 03 constant branches of pectoral nerves -superior branch supplying clavicular fibres of the pectoralis major muscle; middle branch coursing undersurface of the pectoralis major muscle along with the pectoral branch of thoracoacromial artery, supplies the sternal part of the pectoralis major muscle; the inferior branch passes beneath the pectoralis minor muscle supplying it and also the costal part of the pectoralis major muscle. In a similar study, [13] aiming to find the importance of preserving the pectorals minor muscle in a modified radical mastectomy reported an atrophy rate up to 06% in the pectoralis major muscle compared with an atrophy rate of 54% in woman who had their pectoralis minor muscle removed.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the surgeons are supposed to have thorough knowledge about the anatomy of the medial and lateral pectoral nerves and its possible variations to prevent and to minimise the possible complications due to injury to these nerves (denervation) [2]. Even cosmetic surgeons also deal with these nerves during breast augmentations (breast implants) for the females who desire to have better projection and attractive contour for their breasts [3]. This study also helps the plastic surgeons for the safe and functional transfer of the pectoralis major muscle in myocutaneous free flap surgery [4,5].…”

Section: Introductionmentioning

confidence: 99%

Anatomical Study of Pectoral Nerves and its Implications in Surgery

P¹

2014

JCDR

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Introduction: This anatomical study of the pectoral nerves and their innervation is to provide detail informations on the pectoral nerves and their variations in their course, to guide the cosmetic and plastic surgeons for their easy intra operative localization and to improve the understanding of the pectoral muscle innervation, which is very much required during breast reconstruction after modified radical mastectomy (MRM) in breast cancer; axillary dissection; removal of the pectoralis minor muscle, and in harvesting the pectoralis major for myocutaneous head and neck island flap surgeries. Materials and Methods:A total of 50 pectoral region specimens (both right and left sided) from 25 embalmed adult human cadavers (20 female & 05 male) were studied by dissection method. Statistical Analysis:The data were tabulated in Microsoft excel and analysed by using Statistical Package for Social Science (SPSS 17 th version). Mean, Proportion, Standard deviation and Unpaired t-test were applied for analysing the data obtained. Result and Conclusion:In all the specimens, the medial pectoral nerve pierces the pectoralis minor muscle; but as a single trunk in 76%, and as dividing branches in 34% specimens. The extent of costal attachment of the pectoralis minor muscle found to be less than 6.0 cm in cases of the medial pectoral nerve piercing the pectoralis minor muscle as a single trunk. The medial pectoral nerve after piercing the pectoralis minor,

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“…9 Awareness of variations in the anatomy and course of the pectoral nerves is crucial during surgery; for example, when using pectoral muscle flaps during breast surgeries or when the brachial plexus pectoral nerves are transferred to supply a paralysed arm during traction injury repairs. 10,11 Cases in which the LC of the brachial plexus pierces the CB muscle and divides into the McN and the lateral root of the MN are very rare. 4 In the present case, the LC was longer than usual and gave rise to the LP1, LP2 and LRM1 before dividing into the McN and the LRM2 upon reaching the CB muscle.…”

Section: Discussionmentioning

confidence: 99%

Unusual Branching Pattern of the Lateral Cord of the Brachial Plexus Associated with Neurovascular Compression: Case report

Loh

Singh

Suri

2017

SQUMJ

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abstract:The brachial plexus consists of a network of nerves that innervates the upper limbs and its musculature. We report a rare formation of the lateral cord of the brachial plexus observed during the dissection of a 47-year-old male cadaver at the Department of Anatomy, Vardhman Mahavir Medical College, New Delhi, India, in 2016. The lateral cord was exceptionally long with twin lateral pectoral nerves and twin lateral roots of the median nerve. The proximal lateral root of the median nerve was thin in comparison to the medial root of the median nerve. The distal lateral root of the median nerve was thicker and followed an unusual course through the coracobrachialis muscle. In the lower third of the arm, the median nerve and the brachial artery-along with its vena comitans-spanned through the brachialis muscle. Surgeons, anaesthesiologists, radiologists and anatomists should be aware of such anatomical variations as they may result in neurovascular compression.

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The anatomy of the pectoral nerves and its significance in breast augmentation, axillary dissection and pectoral muscle flaps

Cited by 24 publications

References 23 publications

Selective pectoralis major muscle denervation in breast reconstruction: a technical modification for more effective and cosmetic results

Selective pectoralis major muscle denervation in breast reconstruction: a technical modification for more effective and cosmetic results

Anatomical Study of Pectoral Nerves and its Implications in Surgery

Unusual Branching Pattern of the Lateral Cord of the Brachial Plexus Associated with Neurovascular Compression: Case report

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