Plastic Surgery>>>>>Breast, trunk and perineum
Question 4#

Which of the following nerves provide the main innervation to the NAC?

a. The 2th lateral intercostal nerve
b. The 3th lateral intercostal nerve
c. The 4th lateral intercostal nerve
d. The 5th lateral intercostal nerve
e. The 6th lateral intercostal nerve

Correct Answer is C

Comment:

The 4th lateral intercostal nerve. The breast is innervated by lateral and anterior cutaneous branches of the second to the sixth intercostal nerves. The NAC is always innervated by both the anterior and lateral 3th-5th intercostal nerves. The deep branches of the lateral nerves run below or within the pectoralis fascia. At the mid-clavicular line, they turn 90° and continue through the glandular tissue towards the posterior surface of the nipple. The 4th lateral cutaneous branch is the most constant nerve to the nipple, observed in 93% of breasts. The anterior cutaneous branches of the intercostal nerves travel superficially to reach the medial edge of the areola.

References:

1. Schlenz I, Kuzbari R, Gruber H, Holle J. The sensitivity of the nipple-areola complex: an anatomic study. Plast Reconstr Surg 2000; 105(3): 905-9.