Anatomy of the vascular pedicle of the internal mammary artery perforator (IMAP) flap as applied for head and neck reconstruction  Pascal P.A. Schellekens, Emma C. Paes, Joris J. Hage, Martijn B.A. van der Wal, Ronald L.A.W. Bleys, Moshe Kon  Journal of Plastic, Reconstructive & Aesthetic Surgery  Volume 64, Issue 1, Pages 53-57 (January 2011) DOI: 10.1016/j.bjps.2010.03.054 Copyright © 2010 Terms and Conditions

Figure 1 In this case the costal cartilage of the second rib was removed (marked with an asterisk), depending on the origination of the dominant perforator at this right side. IC: intercostal space; IMA: internal mammary artery; PM: pectoralis major muscle. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011 64, 53-57DOI: (10.1016/j.bjps.2010.03.054) Copyright © 2010 Terms and Conditions

Figure 2 The length of the enhanced vascular pedicle length was defined as the length of the dominant perforator (A) plus the additional length provided by the IM vessels up to the level of the first costal cartilage (marked with an asterisk) (B). Note that the perforator of the second intercostal space is the dominant perforator in this case. IMAP: internal mammary artery perforator, IMA: internal mammary artery; IC: intercostal space. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011 64, 53-57DOI: (10.1016/j.bjps.2010.03.054) Copyright © 2010 Terms and Conditions

Figure 3 The vascular pedicle was accompanied by an individual nerve branch of the anterior intercostal nerve, in all cases. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011 64, 53-57DOI: (10.1016/j.bjps.2010.03.054) Copyright © 2010 Terms and Conditions