Microsurgical Dissection of Fresh Human Mastectomy Specimens for Visualization of Breast Fascial and Ligamentous Support Structures.

Ligamentous and fascial support structures, such as Cooper's ligaments and the superficial fascial system, are important structural components of the female breast, contributing to breast shape, mechanical support, and surgical plane definition during breast surgery. Although previous studies have investigated these structures through cadaveric dissection, intraoperative observation, and biomechanical analysis, there have been no reports describing their relationships using microsurgical dissection of fresh human breast tissue. In this study, fresh nonfixed breast tissue specimens were obtained from patients undergoing prophylactic mastectomy and sectioned into 2-cm-thick sagittal slices by a breast pathologist. Microsurgical dissection of each slice was performed under approximately 5×-10× magnification to visualize and examine Cooper's ligaments and the superficial layer of the superficial fascia (SLSF) and deep layer of the superficial fascia (DLSF). Using this protocol, microsurgical dissections were completed in 24 breast tissue specimens, enabling visualization of the observed structural continuity between Cooper's ligaments, the SLSF, the dermis, the DLSF, and the pectoral fascia. Specifically, Cooper's ligaments were observed extending through the SLSF into the dermis and posteriorly through the DLSF toward the fascia overlying the pectoralis major muscle. This protocol enables direct visualization of the fascial-ligamentous support network of the breast and facilitates anatomical understanding of the relationships among these structures. This study and its protocol may serve as valuable educational and research resources for breast surgeons, plastic surgeons, and cross-disciplinary researchers seeking a better understanding of the fascial-ligamentous support structures of the breast.