Breast reconstruction with the profunda artery perforator flap

Robert J. Allen, Nicholas T. Haddock, Christina Y. Ahn, Alireza Sadeghi

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

BACKGROUND: The use of perforator flaps has allowed for the transfer of large amounts of soft tissue with decreased morbidity. For breast reconstruction, the deep inferior epigastric perforator flap, the superior and inferior gluteal artery perforator flaps, and the transverse upper gracilis flap are all options. The authors present an alternative source using posterior thigh soft tissue based on profunda artery perforators, termed the profunda artery perforator flap. METHODS: Preoperative imaging helps identify posterior thigh perforators from the profunda femoris artery. These are marked, and an elliptical skin paddle, approximately 27 × 7 cm, is designed 1 cm inferior to the gluteal crease. Dissection proceeds in a suprafascial plane until nearing the perforator, at which point subfascial dissection is performed. The flap has a long pedicle (approximately 7 to 13 cm), which allows more options when performing anastomosis at the recipient site. The long elliptical shape of the flap allows coning of the tissue to form a more natural breast shape. RESULTS: All profunda artery perforator flaps have been successful. The donor site is well tolerated and scars have been hidden within the gluteal crease. Long-term follow-up is needed to evaluate for possible fat necrosis of the transferred tissue. CONCLUSIONS: The authors present a new technique for breast reconstruction with a series of 27 flaps. This is an excellent option when the abdomen is not available because of the long pedicle, muscle preservation, ability to cone the tissue, and hidden scar.

Original languageEnglish (US)
JournalPlastic and Reconstructive Surgery
Volume129
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Perforator Flap
Mammaplasty
Arteries
Thigh
Cicatrix
Dissection
Fat Necrosis
Abdomen
Breast
Morbidity
Muscles
Skin

ASJC Scopus subject areas

  • Surgery

Cite this

Breast reconstruction with the profunda artery perforator flap. / Allen, Robert J.; Haddock, Nicholas T.; Ahn, Christina Y.; Sadeghi, Alireza.

In: Plastic and Reconstructive Surgery, Vol. 129, No. 1, 01.2012.

Research output: Contribution to journalArticle

Allen, Robert J. ; Haddock, Nicholas T. ; Ahn, Christina Y. ; Sadeghi, Alireza. / Breast reconstruction with the profunda artery perforator flap. In: Plastic and Reconstructive Surgery. 2012 ; Vol. 129, No. 1.
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