Restore natural shape and softness after mastectomy with PAP flap breast reconstruction. This advanced microsurgical technique uses tissue from your upper thigh to rebuild your breast without implants. Dr. Jordan M.S. Jacobs and our expert team specialize in this procedure, offering safe, precise, and natural-looking results in New York.
Rebuild Natural Breasts Using Your Thigh Tissue
The PAP flap, or profunda artery perforator flap, is a type of autologous breast reconstruction that uses skin, fat, and blood vessels from the back of your upper thigh to create a new breast mound. This technique is ideal for women who lack sufficient abdominal tissue for other flap procedures, such as the DIEP flap. Because it preserves the thigh muscles, recovery is typically smoother. The result is a soft, natural-looking breast with minimal visible scarring.
You May Consider PAP Flap Reconstruction If:
- You have insufficient abdominal fat for other flap procedures
- You have had prior abdominal surgeries that limit tissue use
- You have fat available in your upper thigh region
- You prefer reconstruction without implants
- You want a natural-looking, small-to-medium breast size
- You experienced unsatisfactory results from a previous reconstruction
- You are not a suitable candidate for SIEA or DIEP flap techniques
Explore Your Options & Visualize the Results
During your consultation, Dr. Jacobs will conduct a thorough evaluation of your medical history, previous surgeries, body shape, and fat distribution to determine whether the PAP flap is right for you. He will examine your upper thigh region to assess tissue availability and explain how your anatomy affects your surgical choices. You’ll also learn about the advantages and limitations of the PAP flap compared to other flap options like DIEP or SIEA.
To help you visualize your results, we use the advanced Vectra XT 3D imaging system. This technology creates a detailed, volumetric simulation of your body, allowing you to see how different reconstruction approaches could look on you. Dr. Jacobs will utilize these images to create a personalized surgical plan tailored to your goals and aesthetic expectations.
Your PAP Flap Breast Reconstruction Session
Your PAP flap reconstruction will be performed by Dr. Jacobs using high-precision microsurgical techniques. In the operating room, you’ll be placed under general anesthesia. Dr. Jacobs will make an incision along the crease just below your buttock to access the profunda femoris artery perforators—the blood vessels that supply the tissue in your posterior upper thigh. He will harvest a carefully measured ellipse of skin, fat, and blood vessels, ensuring that the thigh muscle remains untouched to preserve your strength and mobility.
Next, Dr. Jacobs will transplant this tissue to your chest, where he uses a microscope to connect the small vessels from the flap to recipient vessels such as the internal mammary artery and vein. Once blood flow is reestablished, he shapes the tissue into a natural breast mound. The donor site is closed with layered sutures to promote smooth healing.
The Recovery Process After a PAP Flap
After your PAP flap surgery, you’ll remain at our facility for several days so Dr. Jacobs and the care team can monitor your healing. Mild to moderate swelling, bruising, and discomfort in both the chest and thigh areas are common. Pain is managed with medication, and drainage tubes may be placed temporarily to reduce fluid buildup.
You’ll need to wear a chest compression garment for a few weeks to support your new breast shape and minimize swelling. Most patients can return to non-strenuous activities within 4 to 6 weeks, but full recovery may take 2 to 3 months. You should avoid heavy lifting, running, and strenuous physical activity during this time. Dr. Jacobs will provide specific aftercare instructions, including gentle exercises to promote circulation in the chest and thighs.
The Final PAP Flap Results
The PAP flap delivers long-lasting, natural-looking results using your own tissue. Because no implants are used, the reconstructed breast ages naturally with your body and feels soft to the touch.
Most patients are pleased with the improved symmetry and shape, as well as the minimal visibility of thigh scars. Once fully healed, you can expect a shapely, proportionate breast mound that restores your confidence and complements your overall figure.
Why Choose Dr. Jordan M.S. Jacobs?
New York’s Go-to Specialist for Natural-Looking Breast Reconstruction
Dr. Jordan M.S. Jacobs is a board-certified plastic and reconstructive surgeon and a national leader in microsurgical breast reconstruction. With extensive fellowship training in reconstructive and craniofacial surgery from NYU Medical Center, he combines technical surgical excellence with a compassionate, patient-first approach to restore not just physical form but your sense of confidence and wholeness. Schedule a consultation today to learn if the PAP flap is the right option for your breast reconstruction journey.
