Breast Reconstruction with PAP Flap

Abstract

Nowadays, breast reconstruction with autologous flaps is a well-accepted reality. While abdominal flaps are probably the most commonly performed, not all patients are good candidates for that type of autologous reconstruction, because of lack of abdominal tissue, previous surgeries, or inadequate perforators. Alternative autologous options have been developed to face this problem. In the last decade the profunda artery perforator (PAP) has progressively gained importance as alternative option to DIEP flaps. The chapter describes in detail the characteristics of PAP flap, from the origin to the surgical technique and recent updates. In addition to that, as PAP flap cannot be considered an easy flap for a microsurgeon who approaches it for the first time, particular care has been taken to explain tips and tricks that can help in patient selection, surgical planning, and flap harvesting, with the aim of shortening the learning curve and avoiding pitfalls.