The contribution of the thoracic internal artery to the breast's blood supply was studied in 24 fresh breasts. The second perforating artery was the largest in 20 breasts (86.3%). This artery supplies the upper portion of the breast, the nipple–areolar complex, and the subjacent anteromedial region. On the basis of these anatomical findings, we propose a new cutaneous island flap raised from the redundant skin that is normally discarded in reduction mammoplasty. The use of this flap is indicated in breast and thoracic wall reconstruction. A clinical case of such reconstruction is reported.
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