Lumbar Artery Perforator (LAP) Flap

LAP Flap diagram

Breast reconstruction using your own body's tissue from your abdomen with a LAP flap has the advantages of forming a natural appearing and feeling breast without a foreign body that lasts for your lifetime. The LAP flap is a type of autologous breast reconstruction that uses skin and tissue from the lower back and love handle to make a breast. It is a microsurgical procedure meaning that the tissue used to make a breast is detached from the body and then transplanted to the chest, suturing small arteries and veins under a microscope to allow the tissue to survive in this new area. The LAP flap is a great option for women who are not candidates for traditional microsurgical reconstruction from the abdomen (DIEP flap) due to prior surgeries or minimal fat in this region. 

The LAP flap uses an ellipse of skin and fat (the flap) that is taken from the lower back along with the blood vessels that supply it. The flap is then detached from the body and this area is closed to result in a straight scar just above the hip. The flap is transplanted to the chest and blood flow is restored using microsurgery. Because the blood vessels to the LAP flap are quite short, an “extension cord” is needed to reach the vessels in the chest, known as a “graft”. This graft is taken from the abdominal wall, and results in a small 5cm scar in the underwear line. 

Due to the need for multiple surgical sites and changes in positioning during surgery, women that require bilateral reconstructions (two sides) are typically staged. This mean that one side is performed at a time, with an interval of around 2-3 months between procedures. Patients typically stay in the hospital for 2 nights after this procedure. This is a technically complicated procedure and UC Davis is one of the few centers in California to offer this option of breast reconstruction for women. Despite the increased complexity of the surgery, we strive to make your recovery very predictable.

For more information or consultation, please call our clinic at 916-734-7844.