Advanced Thigh Flap Procedure in Natural Breast Tissue Reconstruction

Dr. Luke Cusimano, FACS

Advanced Thigh Flap Procedure in Natural Breast Tissue Reconstruction

Jun 1, 2020 | Breast, Breast Reconstruction

This is the process by which cosmetic surgeons remake a woman’s breast following a mastectomy. Breast reconstruction is playing an essential role in the comprehensive treatment of breast cancer due to its importance to breast cancer survivors. The procedure is done using natural tissue such as muscle, skin, or fat from another body part.

Thigh Flap reconstruction is a procedure in which a section of the adipose, skin, and blood vessels is taken from either the inner or outer thigh and used to reconstruct the breast. There are different ways to rebuild the breasts:


PAP (meaning the profunda artery perforator) is a blood vessel in the gluteal region in the area called the “banana roll.” This technique is considered to be muscle-sparing since it does not use muscles. The flap only takes the profunda artery perforator, a section of the skin around it, and some fat from the posterior upper thigh just below the buttocks to reconstruct the breast. The surgeon uses microsurgery to realign the blood vessels with those in the breast.

Women with small and medium-sized breasts can significantly benefit from this procedure. Women with large breasts may need more tissue to fill the breast and may, therefore, need to add saline and silicone implants to get their desired breast sizes. The procedure leaves the thighs tighter than before, making one look like they had a thigh lift. The process does not cause any damage to the underlying tissue.


This is a great breast reconstruction technique since it uses a traverse skin paddle of the profunda artery perforator designed just below the gluteal crease. It is very similar to the PAP flap, but in this procedure, a vertical incision is made on the inner thighs to get a long flap of skin used in the surgery. This procedure makes use of the redundant outer tissues of the side of the thigh at the saddlebag area. The procedure addresses the concerns posed by other techniques that use the horizontal design. The design reduces complications during healing and avoids the major cutaneous nerves of the posterior thigh. Patients take up to four weeks to get full recovery following the procedure. They may need to wear a compression garment to reduce swelling. Strenuous exercise and heavy lifting can complicate the recovery process and should be avoided during the recovery.


This is a good technique for those who don’t have enough tissue on the abdomen or for those avoiding scars on the abdomen. It is an alternative to DIEP and PAP flap. It uses a section of the upper outer thigh, hip fat, and blood vessels that are transferred t the breast. The procedure is reliable, consistent, and has minimal if any, site complications. LTP flap surgery has the disadvantage of leaving behind a scar that is noticeable on the outer thigh, unlike the PAP flap surgery that does not leave any noticeable scars on the inner thighs. On the other hand, this surgery leaves the thigh and hip area with nicely shaped contours and makes it look slimmer.

Schedule your consultation with Dr. Luke Cusimano for more information about the procedures and advice on which one suits you the best. You can also visit our website or contact our Baton Rouge, LA Office, where our staff will be happy to attend to your queries.