PAP stands for profunda artery perforator, a blood vessel that runs through your thigh. A PAP flap uses this blood vessel, as well as a section of skin and fat from the back of your upper thigh to reconstruct the breast. Because no muscle is used, a PAP flap is considered a muscle-sparing type of flap.
With this type of reconstruction, a section of skin, fat, and blood vessels are cut from the back of your upper thigh, just below the buttocks, and moved up to your chest to rebuild your breast. Your surgeon carefully reattaches the blood vessels of the PAP flap to the blood vessels in your chest using microsurgery.
Because skin, fat, and blood vessels are moved from your thigh to your chest, having a PAP flap means your thigh will be tighter -- as if you had a thigh lift. PAP flap scars are hidden in the crease of your thigh and the crease of your buttocks.
The PAP flap may be a good reconstruction option for women who’ve had earlier abdominal surgery or are very thin and so may not be good candidates for TRAM, DIEP, or SIEA flaps.
The PAP flap is a good option for women with small- to medium-size breasts. If you have larger breasts and your doctor recommends PAP flap reconstruction because of your unique situation, you may need a saline or silicone implant to achieve your desired size.
Learn more about PAP flap reconstruction on these pages: