TDAP Flap Breast Reconstruction Surgery: When and Why to Choose This Option

The below question is answered by Charleston breast surgeon Dr. James Craigie of The Center for Natural Breast Reconstruction.

When would we use the TDAP flap for breast reconstruction and what are the advantages of this procedure?

The TDAP flap or thoracodorsal artery perforator flap is a procedure for reconstructing the breast or partial breast reconstruction and is another of the muscle-sparing flaps.  The procedure allows for the fatty tissue from the side and back to be mobilized and then transferred to the breast without disconnecting its blood supply and performing re‑anastomosis of the small blood vessels.  The tissue that is used is in the area above the latissimus dorsi muscle, which is the largest muscle in the body; however, the procedure does not involve transferring the muscle or destroying the muscle.  The advantages of this procedure are that the tissue can be used for breast reconstruction without performing the microsurgery and without damaging or removing the muscle.  The disadvantages of the procedure are that there is a limited amount of tissue available to use for breast reconstruction and because the blood vessel remains attached and is not divided, there is a limit to the shaping and positioning of the new tissue.  It is most frequently used for reconstruction of a part of a breast, mainly the outside, but in some circumstances can be used for reconstructing the entire breast.  However, this is usually a smaller reconstruction and the amount of skin available is typically limited as well.  The TDAP can be used for transferring fat to the breast at the time of mastectomy or can be used later after mastectomy and the body has healed.

Procedures: Transforming Healthy, Living Tissue
Microsurgery has come a long way since its invention by vascular surgeons in the 1960s. The term refers to any surgery involving a surgical microscope. And it has found one of its best applications in breast reconstruction. Through microsurgery, our skilled surgeons are able to harvest healthy tissue from one part of a womans body and reattach it to the breast area. Through the careful process of attaching blood vessels, microsurgery allows patients to have natural looking breasts made from their own, living tissue. Another benefit is the minimized impact and injury to muscles, allowing patients to enjoy a faster, fuller recovery.

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