A PAP flap when the abdomen is not an option

This patient underwent bilateral mastectomies and breast reconstruction with profunda artery perforator flaps.

The PAP flap takes skin and fat from the posterior thigh, with its blood supply, and transfers it to the breast for a total reconstruction. This patient is thin, so the more traditional abdominal donor site was not a good option.

The PAP flap can provide ample tissue even in thin patients, giving a natural, permanent reconstruction with the scar sitting in the crease between the thigh and the lower buttock.

Dr. Haddock is one of the most experienced surgeons in the world with PAP flaps, having performed over 460 PAP flap breast reconstructions. He has written multiple book chapters on the technique and is invited internationally to speak on it.

​This case was posted twice, in November and December 2024; the two write-ups are combined here.

Figures in this entry are as of December 2024 and are not updated. Current figures are on the procedure pages.