Anatomical basis of pedicles in breast reduction

The mammary gland is composed of multiple tubules acinar pockets in which the secretory layer, connective tissue stroma, and fatty tissue all respond to hormonal and systemic influences. These structures are irrigated by three vascular pedicle branches, from the axillary artery, internal mammary artery, and intercostal artery. This vascular anastomotic arrangement forms the anatomical basis of the flaps used in breast reduction techniques. The veins form a strong subdermal network, latticed with the arterial network. The lymph vessels have three well-defined pedicles, skin, glandular and milk ducts that drain into internal, external, and posterior ducts. The understanding of these anatomical structures determines the selection of different pedicles in breast volume reduction and preservation of the nipple-areola complex circulation.