The PAP (profunda artery perforator) flap procedure is a type of breast reconstruction surgery that uses a patient’s own tissue from the posterior thigh (just below the buttocks) to create a new breast after a mastectomy. Along with the TUG/DUG procedures, the PAP procedure is a preferred type of natural reconstruction for slim women who lack sufficient donor tissue in their abdomen or for women who already have had abdominal surgery.
The PAP flap procedure is one of several autologous (own tissue) breast reconstruction procedures offered at Brigham and Women’s Hospital as an alternative to reconstruction with artificial implants. Like many other forms of autologous reconstruction, the PAP procedure involves the transfer of a complete flap of tissue – including skin, fat, and its accompanying blood supply – to the chest, where the surgeon re-establishes blood flow to the flap through the guidance of a microscope. The flap is then shaped by the surgeon to achieve a very natural appearance and feel to the reconstruction. The PAP flap procedure does not compromise any of the musculature in the patient’s leg, and will not affect the patient’s ability to walk, run, or do other activities after recovery.
Not every woman is a candidate for this type of breast reconstruction, and it is best to discuss the pros and cons of these procedures with your surgeon. The PAP flap is among the newest types of flaps being used for breast reconstruction, and is typically reserved for patients who do not have enough tissue in their abdomen for reconstruction, or for those who have already had prior abdominal surgery. The amount of tissue available for transfer in a PAP flap is typically modest – meaning that it is most ideal for patients with smaller breasts (A or B cup).
What Are the Potential Benefits of This Procedure?
Provides a natural look and feel
Less post-surgical care as compared to artificial implant surgery
Viable option for slender women who don’t have sufficient tissue to take from their abdomen or for women who have had previous surgery of the abdomen
Scar below the buttocks is well hidden
Doesn’t sacrifice any muscle
Who Is a Good Candidate for This Procedure?
You should consider a PAP flap reconstruction if you:
Desire reconstruction using your own tissue
Do not have sufficient abdominal tissue to create a breast mound