Deep Inferior Epigastric Perforator Flap

Perforator flaps represent the state of the art in breast reconstruction. Replacing the skin and soft tissue removed at mastectomy with soft, warm, living tissue is accomplished by borrowing skin and fatty tissue from the abdomen.

PAP Flap
Profunda Artery Perforator Flap

This procedure allows the surgeon to use fat and skin from the posterior thigh underneath the buttock crease for your breast reconstruction. The main advantage of this procedure is the donor site scar falls in the crease of the buttock. This procedure is optimal for patients who have had previous surgery that precludes the use of the abdomen as a donor site.

Gluteal Artery Perforator Flap

For the thin woman or those with otherwise inadequate tummy tissue, the breast may be reconstructed with tissue borrowed from the gluteal area. Skin, fat, and the tiny feeding blood vessels are taken using a fine incision along the panty line.

Superficial Inferior Epigastric Artery Flap

For some women the blood vessels just under the skin in the lower abdomen may be chosen as the feeding vessels for the required tissue. The procedure is otherwise the same as the DIEP flap.

Intercostal Artery Perforator Flap

The skin and fat on the lateral chest wall can be used to augment the breast. This tissue is taken from under the arm, next to the breast. The tissue used is named according to the blood vessels which supply it. The blood supply to this tissue is either from perforators through the muscle between the ribs (intercostal perforator artery or ICAP flap), from the blood vessels in the armpit (axilla), or from perforators through the latissimus dorsi muscle (thoracodorsal artery perforator or TDAP flap). The living tissue is turned over and secured under the breast.

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