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Tuinder et al. Plast Aesthet Res 2024;11:38 https://dx.doi.org/10.20517/2347-9264.2024.40 Page 9 of 10

8. The flap can be harvested as a conjoined or stacked flap for more volume, such as in combination with
the PAP flap, as an L-PAP flap.

9. Additional procedures are often necessary to resolve contour defects and increase symmetry with the
contralateral side of both the reconstructed breast and the donor site.

CONCLUSION
The LTP flap is an excellent alternative to the DIEP flap for autologous breast reconstruction in patients
with sufficient tissue at the literal thigh, which is the case in a large number of women. The plastic surgeon
should adequately prepare surgery by using perforator mapping and making decent preoperative markings
to effectively find the septocutaneous perforators in the posterior septum between the TFL and gluteus
medius muscles at the lateral thigh. Not beveling during flap harvest and donor site closure with additional
quilting sutures optimizes donor site outcomes. Several weeks to months postoperatively, additional
procedures in secondary stages are regularly required to optimize the aesthetics of the reconstructed breast
and donor site. The flap can be performed in a conjoined or stacked manner for additional volume.
Altogether, this makes the LTP flap a versatile option for microvascular autologous breast reconstruction.

DECLARATIONS
Acknowledgments
We would like to thank Greet Mommen, medical and scientific illustrator, for her exquisite anatomical
drawings included in the manuscript.

Authors’ contributions
Conceptualization: Tuinder SMH, Van Rooij JAF, Allen RJ
Made substantial contributions in collecting, searching, scanning literature, and writing the manuscript:
Tuinder SMH, Van Rooij JAF
Performed a supervisory role of the manuscript: Tuinder SMH, Allen RJ

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Written informed consent for publication of images of preoperative and postoperative results was obtained.

Copyright
© The Author(s) 2024.