Lumbar Artery Perforator Flaps in Autologous Breast Reconstruction

The LAP flap is an excellent option in autologous breast reconstruction when the abdominal donor site is unavailable. Performed correctly, elevation of this flap produces excellent contour at both the breast and the donor site. The callipygian con-tour that can be achieved at the donor site paral-lels the results of cosmetic body contouring procedures.A major downside to LAP flap breast recon-struction is the relatively high rate of flap failure (6% to 10%) reported for this procedure. Donor site seroma and postoperative sensory changes at the donor site are also common issues. Size and position of the skin island limit the utility of the LAP flap in patients that require skin envelope restoration.LAP flap surgery is an excellent choice for breast reconstruction in properly selected patients. In spite of certain limitations, the favorable attributes of LAP flap surgery make this approach our preferred nonabdominal flap for breast reconstruction.