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What is the LAP flap?

Lumbar Artery Peforator (LAP) flap reconstruction uses excess skin and fatty tissue from the lower back to reconstruct the breast. More specifically, the donor area of fat comes from the flanks, more commonly known as the “love handles.” The tissue is nourished by a specific blood vessel called the “lumbar artery perforator.”

LAP flap reconstruction is indicated for women who are not candidates for deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. This includes women who lack sufficient fat at the lower abdomen or thigh region. Alternatively, the LAP flap is considered in women who have had previous abdominal surgery, whereby DIEP flap reconstruction is not possible (i.e. previous tummy tuck or major abdominal surgery whereby vessels supplying the DIEP flap have been transected).

What are the benefits of the LAP flap?

  • Volume, shape, and feel of natural native breast
  • Sculpts the waistline and lower back
  • Lifts buttock providing better shape to lower torso
  • Well-hidden scar along the lower back
  • Muscle-preserving procedure
  • Long-lasting result

Who makes a good candidate for the LAP flap?

  • You have excess fat in your lower back area (“love handle” region)
  • You are looking for breasts that look and feel natural
  • You lack sufficient donor fat in the belly
  • You have had previous abdominal surgery

What are the drawbacks of the LAP flap?

  • The vascular pedicle that nourishes the flap (lumbar artery perforator) is a short blood vessel. As such, LAP flap breast reconstruction frequently requires a blood vessel graft from another part of the body (similar to an extension cord) to lengthen the vascular pedicle and allow completion of the microsurgical transfer.
  • It is a slightly longer procedure than other flap-based reconstructions.
  • LAP flap reconstruction requires microsurgical technical expertise with very few surgeons performing this flap.
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