One alternative for those without enough abdominal tissue work with is to use your inner thigh as a donor site. This lets us not only restore the natural look and feel of your breasts, but also gives us the opportunity to improve the shape of your thighs. To do this, we use many of the same principles as a thigh lift. Depending on the location of your blood vessels, we’ll perform this either vertically (with the incision between the front and back of the leg) or transversely (concealing the incision in the gluteal crease).
Profunda Artery Perforator Flap
The PAP flap is Dr. Stalder’s preferred thigh-based flap for autologous breast reconstruction in patients with suitable donor anatomy. This advanced microsurgical procedure uses excess fatty tissue from the upper inner thigh to recreate natural breast volume and shape using your own living tissue, without the need for an implant. It is an excellent alternative to the DIEP flap for patients who may not have sufficient abdominal tissue or whose anatomy makes abdominal flap less suitable.The transferred tissue is supplied by the perforating blood vessels originating from the profunda femoris artery and accompanying vein. Using advanced microsurgical techniques, the small perforating vessels are meticulously dissected through the surrounding tissue while preserving the muscle. The tissue and its blood supply are then transferred to the chest, where the vessels are precisely reconnected under the microscope to re-establish blood flow. The tissue is then molded and contoured to create a natural appearing breast mound.Because each patient’s thigh anatomy, tissue distribution, and vascular pattern are unique, Dr. Stalder carefully plans the location, orientation, and design of the tissue to be harvested. Depending on a patient’s anatomy and reconstructive needs, the incisions may be positioned within the natural gluteal crease or along a more vertical contour of the inner thigh. The donor-site design incorporates the principles of medial thigh contouring, with the goal of optimizing both the reconstructed breast and appearance of the thighs.