What Is PAP Flap Reconstruction? Am I Suitable Candidate for It?

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Q:  I just heard about a PAP flap breast reconstruction?  Is it new?  How do I know if I am a suitable candidate for it?

A: The “PAP” (profunda artery perforator) is another type of muscle sparing technique to reconstruct the breast utilizing extra skin and fat taken from the back of the thigh. Dr Allen called this the “banana roll” flap. The concept is the same as the DIEP, sGAP, SIEA and others sometimes referred to as perforator flaps. There are situations when someone has extra tissue in this area but unlike the TUG flap it does not remove any important leg muscles.  Since lymphedema has been associated with the TUG flap in some published papers, the PAP breast reconstruction procedure is performed carefully and specifically to not disrupt the delicate lymph channels and nodes that if removed or damaged might lead to an increased risk for lymphedema.

James E. Craigie, MD

Read more about the “PAP” reconstruction technique here: Breast_Reconstruction_with_the_Profunda_Artery


Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!


  1. Kathy Brock-Henslee says:

    Can you give me more information on the s Gap Procedure please. I am having this done soon and I would love to see some post op photos..Thank you very much. Looking forword to my surgery…so excited.