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Olla et al. Plast Aesthet Res 2024;11:24 Plastic and
DOI: 10.20517/2347-9264.2024.30
Aesthetic Research

Review Open Access

Profunda artery perforator free flaps for breast
reconstruction

Danielle Olla, Jacob Levy, Jonas A. Nelson, Robert J. Allen

Department of Surgery, Plastic & Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Correspondence to: Dr. Robert J. Allen, Department of Surgery, Plastic & Reconstructive Surgery, Memorial Sloan Kettering
Cancer Center, 321 East 61st Street, New York, NY 10065, USA. E-mail: allenr1@mskcc.org

How to cite this article: Olla D, Levy J, Nelson JA, Allen RJ. Profunda artery perforator free flaps for breast reconstruction. Plast
Aesthet Res 2024;11:24. https://dx.doi.org/10.20517/2347-9264.2024.30

Received: 26 Feb 2024 First Decision: 5 Jun 2024 Revised: 12 Jun 2024 Accepted: 24 Jun 2024 Published: 28 Jun 2024

Academic Editor: Hiroshi Mizuno Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
The gold standard for post-mastectomy autologous breast reconstruction is abdominally based free flaps. For
patients with contraindications to abdominal free flap reconstruction, utilization of other donor sites should be
considered. The profunda artery perforator flap has become a popular option for autologous reconstruction as it
offers many advantages, including a long pedicle, muscle preservation, and easy soft tissue contouring. This review
will provide an extensive outline of the history, anatomy, clinical indications, surgical techniques, and outcomes of
the profunda artery perforator flap. It will also discuss appropriate preoperative imaging (CTA, MRA) and present a
case of a patient who received a profunda artery perforator flap at our institution.

Keywords: Autologous breast reconstruction, profunda artery perforator (PAP) flap, microsurgery

INTRODUCTION
As the number of women diagnosed and surviving breast cancer continues to increase, it is critical to have a
diverse arsenal of options for breast reconstruction to customize care for each patient . While implants
[1-3]
remain the most common modality and provide successful reconstruction for many women, autologous
tissue accomplishes the objective of breast reconstruction while avoiding a permanent prosthesis which can
[4]
be subject to complications such as capsular contracture and rupture . Additionally, patients who undergo
autologous breast reconstruction are more satisfied with their breast reconstruction and experience better

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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