Alternative Flap-Based Breast Reconstruction: The PAP Flap

Abstract

The profunda artery perforator flap, like many perforator-based flaps in breast reconstruction, has evolved from its initial introduction more than a decade ago. It is considered by many to be the priority alternative flap when abdominal flaps are unavailable. Several configurations of the flap may be utilized routinely, making this flap particularly versatile for mild-moderate volume breast reconstruction. Additionally, as reconstructive microsurgeons become more adept, they strive to achieve an esthetically pleasing breast in the first stage. The PAP flap is particularly suited for this endeavor, as its ability to be contoured to simulate a natural breast mound at time of inset is impressive.