PAP Flap Reconstruction

PAP Flap Reconstruction in Austin, TX

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A natural look and feel to a reconstructed breast can be achieved through a profunda artery perforator (PAP) flap reconstruction at Snyder Plastic Surgery at the Breast and Body Center. Our board-certified Plastic and Reconstructive Surgeon Dr. Ned Snyder IV implements a cutting-edge surgical technique, which spares the muscle in your thigh and leaves a scar just beneath the buttocks in a natural crease on the back of your thigh. A PAP flap is a breast reconstruction technique uses the blood vessel that runs through the thigh.

When you do not have enough tissue on your belly, Dr. Snyder may recommend the next best choice, a PAP flap. This reconstruction is best suited for women who are not a candidate for the harvesting of their abdominal tissue either because of previous surgeries or because they do not have the volume of abdomen tissue to make a breast. This can all be discussed in a private consultation in our Round Rock, or Austin, TX office. Snyder Plastic Surgery at The Breast and Body Center wants to help you through this transformative surgery. Call and schedule consultation.

Surgical Technique

A PAP flap is a type of breast reconstruction that uses only your own tissue and is performed at an inpatient facility under general anesthesia. The breast is reconstructed  by Dr. Snyder using skin, fat, and blood vessels from the back of your upper thigh. This technique spares the muscle in your thigh and leaves a scar just beneath the buttocks in the natural crease on the back of your thigh. The first part of the construction is the harvesting of the tissue via liposuction on the thigh, which is the same technique we use in a thigh lift. Then, the breast can be reconstructed with the tissue relocated layer-by-layer to the breast mound. Blood vessels are also reconnected at the new breast site. A PAP flap usually creates a breast the same volume or larger than the breast that was removed in a mastectomy.

During/After Surgery

After your surgery, you will be observed very closely by our experienced post-operative nurses and medical staff. Be prepared for an inpatient stay for several days to monitor your progress. Since a PAP flap breast reconstruction is technically two surgeries combined, we will address both your thigh and breast surgical sites, pain management, hygiene, and incision drains. Once you are discharged, you will need to have help for a few weeks while you recover. You may not be able to move as easily as before your surgery until your body is ready (usually 1 – 6 weeks). Dr. Snyder will want to see you 7 days after discharge for a follow-up appointment to see your progress, help manage your pain, and to make recommendations on how you can recover quickly and with less stress. You will not be able to do strenuous activities (working out, housework, or physical jobs) for many weeks and should not resume them until released from your doctor.

It is very important to look for signs of infection or fever within your incision sites. Please give our practice a call if you have excessive bleeding, fever, or any unusual side effects from the medication after the surgical procedure in your breast or thigh.


How Many Scars?

A PAP flap breast reconstruction will require surgical scars on the breast(s) and at the natural crease of the buttocks and the thigh. Dr. Snyder will perform your surgery with the goal of making your scars as seamless and inconspicuous as possible. Unfortunately, you will have surgical scars, but with time, they should become less prominent.

How Long Is the Surgery?

Your breast construction surgery with the PAP flap surgical technique may take 4 – 6 hours under a general anesthetic. Keep in mind that the more fat that has to be collected from various donor sites on the body, the longer the surgery. 

Am I a Candidate?

If you are a candidate for the PAP flap instead of a DIEP flap, this usually means there was not enough tissue in your abdominal area from a lack of fatty tissue or because you have had a tummy tuck in the past. Dr. Snyder may take into consideration other abdominal surgeries you may have had performed (liposuction, C-Section, appendectomy, hysterectomy, bowel surgery, and others). Most patients in this situation who have had a tummy tuck, are usually more appropriate for a PAP flap reconstruction.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.