PAP Flap

Jandali Plastic Surgery

With advancements in plastic surgery, women now have the opportunity to restore the shape and appearance of their breasts after mastectomy through natural flap reconstruction. The PAP (Profunda Artery Perforator) flap breast reconstruction is a cutting-edge procedure that offers a personalized solution for women looking to reclaim their confidence.

What is PAP Flap Surgery from the Thigh?

The Profunda Artery Perforator (PAP) flap is a type of breast reconstruction surgery that uses tissue from the upper inner and back of the thigh to create a new breast. The PAP flap procedure involves transferring skin, fat, and blood vessels from the upper thigh just below the buttock to the chest wall to reconstruct the breast. The blood vessels that supply the tissue are carefully dissected and reconnected to blood vessels in the chest area, ensuring that the tissue remains alive and healthy.

PAP Flap is an Alternative to the DIEP Flap

The PAP flap is a relatively new technique, developed within the last 10 years as an alternative to the DIEP flap. Like other perforator flaps (like the DIEP flaps), the PAP flap preserves the underlying muscle, which can result in less postoperative weakness and a faster recovery time. It is usually a secondary option for patients that are not candidates for a DIEP flap.

Benefits of the PAP Flap for Breast Reconstruction in Connecticut

There are several benefits of PAP flap breast reconstruction, including:

Natural-Looking Results: PAP flap breast reconstruction uses a patient’s own tissue, which provides a natural-looking and feeling result. The tissue used for reconstruction is similar in texture and consistency to the breast tissue.
No Implants Required: Unlike other breast reconstruction techniques that require the use of implants, a PAP flap uses the patient’s own tissue, reducing the risk of implant-related complications. This is especially important if a patient has had previous radiation therapy.
Reduced risk of complications: Because the PAP flap does not involve the use of an implant, there is a reduced risk of complications such as capsular contracture, implant rupture, or infection.
Long-Lasting Results: PAP flap results are long-lasting and can provide a permanent solution for breast reconstruction. There are fewer surgeries over a patient’s lifetime compared with implants.
Reduced Scarring: Unlike other techniques that require multiple incisions, the PAP flap procedure typically involves a single scar which is hidden underneath the buttock crease.
Improved Body Contouring: In addition to restoring the shape and appearance of the breast, a PAP flap can also improve the inner thigh contour, as removal and transfer of this tissue will have the same effect as a thigh lift.
Improved Self-Esteem and Confidence: Breast reconstruction can help restore a woman’s confidence and sense of femininity, and can have a positive impact on her overall well-being.

Overall, a PAP flap is a safe, effective, and natural-looking solution for women seeking breast reconstruction after mastectomy who are not candidates for a DIEP flap.

How Does the PAP Flap Work?

The PAP flap procedure is a type of autologous breast reconstruction, which means that the tissue used to rebuild the breast comes from the patient’s own body. The procedure involves harvesting a flap of tissue from the patient’s upper thigh and transferring it to the chest area to create a new breast. This tissue is carefully sculpted and molded into the desired shape, and the blood supply to the tissue is reestablished.

The PAP flap procedure is a multi-step surgery that involves the following steps:

Consultation: The first step in the PAP flap procedure is to meet with Dr. Jandali to discuss your goals and determine if the procedure is right for you. Dr. Jandali will conduct a thorough examination and review your medical history to determine if you are a candidate for the procedure. He will carefully assess the thigh area to ensure enough tissue is present and there is enough laxity to be able to perform the surgery.
Imaging: Before the procedure, Dr. Jandali will order a CT angiogram to assess and map out the perforator (small blood vessels) in the thigh area. This helps determine which vessels are the best to use for the surgery and their location.
Anesthesia: The PAP flap procedure is typically performed under general anesthesia. In addition, nerve blocks are performed in the breast area to help with postoperative pain control. You will be asleep throughout the procedure and will not feel any pain.
Incision and Harvesting of Tissue: Dr. Jandali and his team will make an incision in the upper thigh to harvest the flap of tissue. The tissue will be carefully detached from its original blood supply.
Transfer of Tissue and Reestablishment of Blood Supply: The harvested tissue will be transferred to the chest area. The blood vessels will be reconnected to new blood vessels in the breast area to allow blood flow into the tissue and out of the tissue, ensuring that the tissue remains alive and healthy. The tissue will then be shaped and molded into the desired shape of a breast.
Closure: The incisions will be closed with dissolvable sutures and drains. Patients are moved to the recovery room to begin the post-operative healing process.
Recovery: Recovery from the PAP flap procedure typically takes several weeks, and patients can expect some discomfort and swelling during this time. Physical activity will need to be limited, and patients will need to attend follow-up appointments to monitor their progress.

Is PAP Flap Right for You?

The ideal candidate for PAP flap breast reconstruction is a woman who:

Has undergone a one side mastectomy or double mastectomies.
Is not a candidate for DIEP flaps due to previous abdominoplasty, other abdominal surgeries, or not enough abdominal tissue.
Is in overall good health, without any medical conditions that could increase the risk of complications.
Has a sufficient amount of skin, fat, and laxity of the upper inner thigh area.
Has realistic expectations for the procedure and the results.
Is willing to undergo the recovery process and comply with post-operative care instructions.

Frequently Asked Questions

What is PAP Flap breast reconstruction?

PAP Flap is an autologous tissue breast reconstruction technique that uses tissue from the patient’s upper posterior thigh to reconstruct the breast mound, offering a natural look and feel.

Why would someone choose PAP Flap over other reconstruction methods?

PAP Flap is often chosen for its natural results, suitability for patients who can’t have implants or lack adequate tissue in typical donor areas, and its discreet scarring hidden by most underwear and bathing suits.

What is the process of PAP Flap breast reconstruction?

The process involves an initial consultation, the surgical procedure, a recovery phase in hospital, healing at home, and possibly further procedures for nipple creation and symmetry adjustments.

How can I prevent complications in PAP Flap breast reconstruction?

Ensuring optimal health before surgery, strictly following your doctor’s pre-operative and post-operative instructions, and maintaining a healthy lifestyle after the procedure can help mitigate risks.

Schedule a Consultation Today for PAP Flap Breast Reconstruction

Dr. Jandali will provide a personalized plan for your PAP flap breast reconstruction procedure to ensure the best possible outcome.

The team at Jandali Plastic Surgery in Fairfield County, Connecticut, is here to help. Our experienced team is dedicated to helping women after breast cancer. We invite you to schedule a consultation to learn more about this innovative and cutting-edge procedure and begin your journey to restoration.

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I recently had a double mastectomy with reconstruction and Dr. Jandali is not only great at what he does, he is an amazing surgeon and perfectionist that is kind and warm with an exceptional staff. Each person I have met in his office is wonderful all across the board his office is a fantastic place that I highly recommend to anyone, you will not be uncomfortable or disappointed. All the girls on his team are truly the BEST he sure knows how to pick his staff, LOVE them!!! I look forward to my visits and am beyond grateful to be in the best care. Thankful to all of you for my experience I can't say enough. :-)

This is a wonderful place. I came to Dr. Jandali’s office after finding out I had breast cancer. It was such a scary time in my life but Dr. Jandali made me feel comfortable and explained my options for reconstruction after mastectomy. I opted for the DIEP flap and am very happy with the results. Dr. Jandali basically performs magic in making things look better. He and his entire staff are so professional and kind. The PAs Jennifer, Brielle, and Shelby are amazing. They spent so much time with me explaining everything along the way and answering any questions I had. Plus, it is obvious that they really care. I am actually going to miss seeing them.

I met Dr. Jandali and his team after making the decision to undergo a double mastectomy with reconstruction. At 32 years old, learning I was BRCA2 positive and having two toddlers at home, I was so scared and didn’t know what to expect. Between Dr. J & Shelby, I was immediately put at ease and walked through the entire process. Shelby, was and is, still my strength when I walk into the office. She has reassured me, talked me through all my emotions, and has been AMAZING on this journey. I can’t thank Shelby enough. And Dr. J and his expertise, made me feel like myself again, it’s like I came out of this better then ever! Thank you all!!

I cannot recommended Dr. Jandali enough for any women who are undergoing DIEP flap reconstructive surgery after mastectomy. Dr. Jandali and his phenomenal staff are so not only knowledgeable and extremely capable but kind and sensitive to the situation that their patients are going through. They take their time to explain every step of the surgery, even taking the time to draw pictures and answer any questions I had. I was very well informed about what would take place and my expectations were well exceeded. Being diagnosed with breast cancer was a challenge but I cannot express my gratitude that I had Dr. Jandali and his team on my side.

I walked into Dr. Jandali’s office for a consultation with so much sadness and fear of what lie ahead for me. I had previously met with a few other plastic surgeons but knew after meeting with Dr. Jandali that he would be my surgeon. He was beyond thorough in his explanation of the whole procedure from start to finish and I could tell he would be overly cautious to prevent infection or any chance of something going wrong. He is a perfectionist in every sense of the word. In addition his staff was always so personal and professional and available to answer any and all questions.

After being diagnosed with breast cancer I was scared. I immediately felt at ease when I had my first visit with Dr. Jandali. He explained everything in detail about the breast reconstruction I would be having and made me feel at ease. On surgery day his amazing PA Brielle made sure I knew she was right there in the operating room with me and held my hand to comfort my anxiety until I was asleep. I’m so happy with my results after only 1 week post op. The entire staff is so friendly.