During PAP flap surgery, an incision is made in the back of your upper thigh just below your buttocks, and a triangular section of skin, fat, and blood vessels is taken from your thigh and moved up to your chest and formed into a breast shape. The tiny blood vessels that feed the tissue of your new breast are matched to blood vessels in your chest and carefully reattached under a microscope.
PAP flap reconstruction surgery takes about 3 to 5 hours.
After PAP flap reconstruction surgery: You’ll be moved to the recovery room after surgery, where hospital staff members will monitor your heart rate, body temperature, and blood pressure. If you’re in pain or feel nauseous from the anesthesia, tell someone so you can be given medication.
You’ll then be admitted to a hospital room. For a PAP flap, you usually stay in the hospital for about 3 days.
Your doctor will give you specific instructions to follow for your recovery. For detailed information on how to care for the dressings, stitches, staples, and surgical drains, visit the Mastectomy: What to Expect page.
It can take about 4 weeks to recover from PAP flap reconstruction surgery. Your doctor may recommend that you wear a compression girdle for up to 8 weeks after surgery. Because you’ve had surgery at two and maybe four sites on your body (your chest and your thigh or both thighs), you might feel worse than someone who had mastectomy alone and it will probably take you longer to recover. You’ll have to take care of two and maybe four incisions: on your breast(s) and on your thigh(s). You may have another incision and a surgical drain if you also had axillary dissection (under-arm lymph node removal) at the same time.
It’s important to take the time you need to heal. Follow your doctor’s advice on when to start stretching exercises and your normal activities. You usually have to avoid strenuous sports, sexual activity, and lifting anything heavy for about 4 to 6 weeks after PAP flap reconstruction. Because of the incision location, PAP flap procedures may be more likely to have healing problems in the area where the donor tissue was removed.