LAP Flap

LAP Flap Breast Reconstruction

A Natural, Muscle-Preserving Approach

LAP (Lumbar Artery Perforator) Flap breast reconstruction offers a unique way to rebuild the breast using the soft tissue of the waistline at the lower back and flank area (often referred to as the “love-handle” region). Because the muscle remains intact, this approach can help minimize postoperative discomfort and preserve strength—while also providing an aesthetic contour to the waist and buttock.

Many women love the LAP donor site because in addition to allowing restoration of well projected breasts, the buttock is lifted and the waist narrowed with the lumbar artery perforator flap donor site. One of our patients once referred to this procedure as having a “Jessica Rabbit” effect because of the cosmetic enhancement that surgery had on her waistline and buttock. 

This procedure is offered by only a small subset of those surgeons who perform microsurgical breast reconstruction. Our group has been amongst the early pioneers of LAP flap breast reconstruction in the United States, and we have authored numerous papers and text book chapters about this procedure.

What is LAP Flap Breast Reconstruction?

In a LAP Flap procedure, skin and fat from the lower back and hip region are transferred to the chest using advanced microsurgical techniques. As with all perforator flap surgeries, the necessary blood vessels are carefully dissected without removing any muscle—helping to protect your donor site function. After the flap is transferred, blood flow is re-established in the newly reconstructed breast to create a natural, soft result. When only one breast is reconstructed, the opposite side of the lower back can be contoured to achieve a symmetrical appearance.

The LAP Flap uses natural tissue from the lower back and hip region  to restore a breast removed by mastectomy.

Why Choose LAP Flap Breast Reconstruction?

• Uses your body’s own tissue for a natural feel
  Tissue harvested from the waistline and flank helps recreate a breast that looks and feels natural.
• Muscle remains intact
  Preserving muscle can reduce postoperative discomfort and protect the strength of your donor area.
• Waistline contouring
  Because tissue is removed near the buttock region—similar to a cosmetic buttock-lift—many women notice a more slender silhouette with naturally accentuated curves.
• Concealable scar placement
  The resulting scar typically lies at the junction of the lower back and buttock, where it is easily hidden by most clothing or swimwear.
• Potential for symmetry
  If only one breast requires reconstruction, tissue can be taken from the other side of the waistline to balance the overall contour.

Benefits of Muscle Preservation

Since the LAP Flap is a muscle-sparing approach, postoperative discomfort may be minimized. The delicate blood vessel dissection ensures that muscle is neither divided nor removed, which can:

• Reduce pain and the need for narcotics.
• Help you recover more quickly, with fewer activity restrictions.
• Preserve overall donor site function and strength.

A Natural Look with Added Waistline Contouring

Many women appreciate that using the lower back (or “love-handle”) area for flap harvest can improve the contour of the waistline and lift the buttock. The scar typically follows the curve of the lower back and buttock junction, making it easier to conceal in clothing and swimwear.

Refining Your Results with Stage II Procedures

About three months after the initial reconstruction, additional outpatient procedures—often referred to as Stage II—can be done to:

• Refine the shape of your reconstructed breast.
• Rebuild nipples if they were removed during mastectomy.
• Achieve better symmetry when only one breast has been reconstructed.

These optional procedures are usually performed on an outpatient basis, allowing your surgical team to tailor the final result to your preferences.

Frequently Asked Questions

• Can I consider the LAP Flap if I have had previous abdominal surgeries or other reconstructive procedures?
  Absolutely!  The love handle area often has sufficient tissue for breast reconstruction, and can be an excellent choice for women who have had previous abdominal surgery, including a tummy tuck, or when the abdomen is otherwise not an appealing or viable option as a donor site.
• How does the recovery timeline for a LAP Flap compare to other flap procedures?
  Similar to other perforator flap procedures, this procedure requires a 2 or sometimes 3 night hospital stay followed by recuperation at home. Pain is not a significant issue for most LAP flap patients, and narcotics are rarely needed after you leave the hospital, if at all. 
  
• How soon after mastectomy can I have a LAP Flap breast reconstruction?
  LAP flap breast reconstruction can be done in conjunction with a mastectomy or at a later date if a patient has not had reconstruction or has had a reconstruction that is unsatisfactory.

Explore All Perforator Flap Options

Not sure if the LAP Flap is the ideal choice for you? Our practice offers a variety of advanced perforator flap procedures and breast reconstruction options to meet your personal needs.

View All Perforator Flap Procedures

We Are Here to Help

If you’re considering LAP Flap Breast Reconstruction or want to explore your full range of options, contact our team today. We are here to guide you every step of the way, ensuring your reconstructive journey is as comfortable and informed as possible.