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PAP Flap

Natural breast reconstruction after a mastectomy can create lifelike results, but not all women are good candidates for a DIEP flap.

Profunda artery perforator (PAP) flap reconstruction takes tissue from your thighs so women with slimmer stomachs can undergo treatment.

Dr. Ravi Tandon can expertly perform a PAP flap procedure at our Metairie, LA, surgical center to help you restore your feminine figure.

A Brief Overview of the PAP flap Procedure

During PAP flap surgery at our New Orleans, LA, area practice, Dr. Tandon will remove skin, fat, and blood vessels, including a blood vessel called the profunda artery perforator (PAP), from the back of your upper thigh. He will then transfer this autologous tissue to reconstruct your breasts. PAP flap is a muscle-sparing technique suitable for many women who don't have enough excess skin and fat on their abdomen for other natural breast reconstruction procedures, like DIEP flap.

Are You Ready to Learn More? Contact Our New Orleans Practice Today

The number of breast reconstruction options following a mastectomy can be overwhelming. The best way to determine which option is best for you is to speak with an experienced plastic surgeon. While Dr. Tandon can perform many plastic surgery procedures, breast reconstruction is his specialty. He will take the time to get to know you and your goals so he can recommend the best treatment.

Contact our practice serving New Orleans, LA, to request your consultation and learn more about our breast reconstruction options.

(504) 455-1000

"I have a better figure than I had before breast cancer."

1

Kayla Hanna

2022

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I can't say enough positive things about Dr.Ravi Tandon. He made me feel my very best when I was at my absolute worst. He is so compassionate, understanding, caring, and thorough, and makes you feel like a person, not just another patient. His surgical experience is like none other. He did my breast reconstruction surgeries and his work is pristine!... Dr.Ravi Tandon is the best and I would recommend him to anyone. 

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Ruth Komar

2022

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Dr. Tandon and his staff are the absolute best!... I am eternally grateful it was Dr. Tandon and his staff that were to be my Plastic Surgery team. They saw me for consultations at least 3 times prior to surgery where I was treated with deep compassion and professionalism. They explained my options thoroughly and I was confident that I was in the best care possible. Now, I can say, I have a better figure then I had before breast cancer. 

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Exploring Candidacy Factors To Consider Before Your Consultation

The only way to know if the PAP method is right for you is to request a consultation at our New Orleans–area practice. Before your consultation, consider the following candidacy factors:

Slim Figure

Women who are very thin or don't have enough excess tissue around their abdomen for DIEP flap may be good candidates for PAP flap. 

Previous Surgery

Women who have had previous abdominal surgery tend to be better suited for the PAP method over DIEP flap surgery.

Both Breasts

Women who only need one breast reconstructed may be better suited for another reconstructive procedure, as the surgery can leave one thigh smaller than the other.

Breast Size

PAP flap surgery tends to work best on women with small to medium-sized breasts. Women with larger breasts may need to add a stacking method or implants to their treatment to achieve their desired size.

The Stacked Flap Technique Enhancing Size Without Implants

The stacked flap method is an advanced plastic surgery technique that combines two types of flaps from separate donor sites to form your reconstruction. Dr. Tandon can reconstruct large breasts by only using autologous tissue without needing an implant. Thin patients or patients who want to achieve a large breast size could make good candidates for this flap method.

Review Your Options How to Decide if the PAP Method is Best for You

The more you understand your reconstructive options, the more you can discuss them with Dr. Tandon during your consultation at our New Orleans–area practice. He can answer any questions you have and help create a reconstructive plan perfectly suited to meet your needs.
Illustration of PAP flap tissue area

PAP Flap

The PAP flap procedure will remove tissue from your thigh and transfer it to your breast without removing any muscle. While recovery for this procedure is shorter than methods that remove muscle, it is longer than traditional breast reconstruction with implants. The PAP flap method restores your bustline, slims your thighs, and enhances your contours in one surgery.

DIEP Flap

Similar to the PAP method, DIEP flap surgery uses autologous tissue to reconstruct your breasts; however, it uses the abdomen as its donor site. DIEP stands for deep inferior epigastric perforator artery, which runs through the abdomen. This procedure takes a flap containing blood vessels, fat, and skin from the abdomen and transfers it to the breast without removing any abdominal muscle. This helps reduce your risk of hernia during recovery.

Learn More About DIEP FLap

Implants

Breast reconstruction with implants is a widely performed plastic surgery method used to increase a woman's breast size, but it can also be used to reconstruct a breast after mastectomy. Our New Orleans practice offers both saline and silicone implants. This is a great surgical option for patients who may not have enough excess tissue for a full flap procedure. 

Learn More About Implants

Hybrid Reconstruction

Hybrid breast reconstruction uses autologous tissue and implants to achieve your desired look. This is a great option for patients who want the natural look and feel of autologous reconstruction, but don't have enough excess tissue to reach their goal size. Dr. Tanon will perform a flap procedure and then insert implants to complete the transformation.

Learn More About Hybrid Reconstruction

Your Breast Reconstruction Options Compared

Type of Surgery

Autologous
Tissue Used

Donor Site Fatty Tissue Used
PAP Flap Thigh
DIEP Flap Abdomen
Implant Silicone or Saline Implant
Hybrid Abdomen and Implant

Meet With a Board-Certified Plastic Surgeon Request Your Consultation at Tandon Plastic Surgery

Dr. Tandon

You need an experienced plastic surgeon to handle your care when facing a mastectomy. Dr. Tandon specializes in reconstructive surgery and is passionate about helping breast cancer survivors restore their confidence. He completed a reconstructive microsurgery fellowship at New York University Medical Center and achieved board certification from the American Board of Plastic Surgery. 

As a patient-focused practice, Dr. Tandon and his team strive to ensure you are comfortable and relaxed at every visit. Our office is filled with comfortable sofas and seating to promote a relaxed atmosphere and eliminate the sterile feel of a typical doctor's office. 

Contact our New Orleans, LA, practice to request your consultation and see why patients choose Dr. Tandon. During your visit, Dr. Tandon can answer any of your questions and confidently recommend the best treatment option for your needs. 

"Dr. Ravi Tandon is an incredible surgeon."

1

mustangcita

2022

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Dr. Ravi Tandon is an incredible surgeon and a miracle worker that makes you feel comfortable immediately. He never makes you feel rushed even though I know he is always super busy... The entire staff is always professional and helpful. I had BC reconstruction surgery with Dr. Tandon with results far above anything I could ever imagine... Thank you hardly seems like enough praise for what they do for so many of us everyday.

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Tricia O'Connor

2022

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Dr.Tandon is the best! After being diagnosed with early stage breast cancer Dr. Tandon put my mind to ease at our first meeting. He is compassionate, patient, funny and very talented. A year after my final surgery I can say I’m very pleased with my reconstruction and would recommend Dr. Tandon to anyone in the same situation.

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The PAP Flap Process What To Expect During Surgery

PAP flap surgery can be performed either immediately following a mastectomy or delayed for complex cases. Immediate breast reconstruction is typically preferred, so it is best to meet with our New Orleans surgeon before your mastectomy to discuss treatment. 

Whether your treatment is immediate or delayed, you can expect the following general steps of surgery.

PAP flap surgery typically takes between 3 to 5 hours.
PAP flap surgery typically takes between 3 to 5 hours.

Anesthesia

General anesthesia will be used to ensure you are asleep and comfortable throughout the entire procedure.

Incisions

Dr. Tandon will make incisions on the back and inside of your upper thigh. The incisions are typically hidden in the crease of your thigh and just underneath your buttocks.

Extraction

Dr. Tandon will remove a triangular section of tissue from the donor site.

Placement

The flap of skin, fat, and blood vessels removed from the donor site will be transferred to the breast. Dr. Tandon will surgically attach each blood vessel in the flap to the ones in your chest to ensure proper nourishment.

Sutures

Dr. Tandon will suture the incisions closed. All incisions made will be strategically placed to help minimize visual scarring.

Recovery

Most patients will stay in the hospital for around three days to be monitored. Once released, it can take anywhere between four and eight weeks to fully recover. 

Risks and Side Effects of PAP Flap Reconstruction

Like any surgery, there are some risks to this breast reconstruction procedure. However, when you choose an experienced plastic surgeon like Dr. Tandon, your chance of risks or surgical complications is lower. Standard side effects like tenderness, discomfort, swelling, and bruising are to be expected and can be managed with pain medication and a cold compress.

Tissue Breakdown

This is a rare side effect that occurs when the tissue in the flap that was transferred from your thigh is not getting enough circulation. This can lead to necrosis (tissue death). Call our New Orleans practice immediately if you notice the skin turning dark blue or black, it is cold to the touch, if you have developed an open wound, or if you are running a fever. Small areas of necrosis can be trimmed away by our surgeon, but if left untreated, the entire flap may need to be removed. 

Lumps in Your Flap

If the fat in your transferred flap does not get enough circulation, the fat can be replaced with scar tissue. This scar tissue is dense and firm to the touch and can feel like lumps in your breasts. This rare side effect is known as fat necrosis. While these lumps may go away on their own, contact our practice if you are experiencing discomfort or if the lumps are getting worse. Our surgeon can remove these lumps to restore your breast's natural appearance and feel.

"I am blessed to have Dr.Tandon as my surgeon."

1

Claudette Tolbert

2022

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Dr. Tandon is an outstanding surgeon with excellent bedside manners. He listens to his patient's concerns and does his best to make her look and feel good about herself. I am blessed to have Dr.Tandon as my surgeon.

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Loredana

2022

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My experience with Dr.Tandon was very positive.I trusted him and I ‘m very satisfied with the results. He and his staff are excellent .Nobody can face such big operation as double mastectomy without having a professional work team.

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Can I Afford Breast Reconstruction? Yes, It Is Covered By Insurance

According to The Women's Health and Cancer Rights of 1998 (WHRCA), your health insurance company is required to cover your mastectomy and any breast reconstruction procedure. 

headshot of Dr. Ravi Tandon, Breast Reconstruction Surgeon in New Orleans

Ravi Tandon, M.D.

Dr. Ravi Tandon is one of the most sought after plastic surgeons who is highly skilled and has trained in the latest breast reconstruction techniques. He is affiliated with various plastic surgery organizations: 

  • American Society of Plastic Surgery
  • American Society for Reconstructive Microsurgery
  • Louisiana Society of Plastic Surgeons

If you are exploring breast reconstruction during, immediately after, or long after your mastectomy, our compassionate team can help. To learn more about your options, request a consultation online or call our practice at (504) 455-1000.

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Ste 200
Metairie, LA 70002

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