TDAP Flap

TDAP Flap Breast Reconstruction

A Natural, Muscle-Preserving Approach

The Thoracodorsal Artery Perforator (TDAP) flap offers a versatile option for breast reconstruction using tissue from the upper back. By meticulously harvesting skin and fat—without removing the latissimus dorsi muscle—this approach helps maintain arm and shoulder strength while providing natural-looking volume. This flap is especially well-suited for partial breast reconstruction or refining prior reconstructions.

What is TDAP Flap Breast Reconstruction?

A TDAP flap is composed of skin and fat from the upper back, alongside the perforator blood vessels that keep the flap healthy. Though it originates from the same area as a latissimus dorsi flap, no muscle is sacrificed with a TDAP flap. Once the flap is prepared, it is rotated and tunneled under the skin from the back to the chest. Because the blood vessels do not need to be detached and microsurgically reattached, microsurgery is not required, and many patients only need one night of hospitalization.

Why Choose TDAP Flap Breast Reconstruction?

• Muscle Preservation - By sparing the latissimus dorsi muscle, you retain normal function in the arm and shoulder.
• Natural Tissue Option - Ideal for adding volume to partial reconstructions (e.g., after lumpectomy) or to enhance previous breast reconstructions—without relying on implants.
• Simpler Post-Op Recovery - Since microsurgery is not needed for this perforator flap, it is not necessary to stay overnight in the hospital, and recovery can feel less complex than with other flap procedures.
• Concealable Scar Placement - The incision can typically be made along the bra line, keeping your scar discreet under everyday clothing, and even many bating suit styles.
• Versatile for Various Breast Issues - The TDAP flap can be adapted for use in many situations as diverse as correcting tubular breasts without implants to performing partial breast reconstruction after lumpectomy to supplementing an existing reconstruction with additional volume.

How It Compares

While TDAP flaps may not have sufficient volume to reconstruct a woman’s full breast in every case, they are an excellent choice for partial reconstruction or to fine-tune shape and size when combined with other techniques. This muscle-sparing approach helps many women achieve a more natural outcome with fewer functional compromises.

Refining Your Results

Just like other perforator flap procedures, Stage II refinements (e.g., shaping the reconstructed breast or performing nipple reconstruction) can be done, if necessary to optimize results. These outpatient procedures allow for precision adjustments to meet each patient’s goals for appearance and symmetry.

See the Transformation: Before and After TDAP Flap Reconstruction

To better understand the potential of a TDAP flap, browse our before-and-after photo gallery (coming soon). These examples highlight how upper back tissue can be used to improve outcomes after partial or total breast reconstruction.

 

(A) The TDAP flap is a perforator flap composed of skin and fat harvested from the upper back. The blood vessels that supply this flap are meticulously separated from the latissimus dorsi muscle so that muscle is not sacrificed and strength in the arm and shoulder are preserved. (B) The TDAP flap is rotated and “tunneled” under the skin from the back to the chest; microsurgery is not necessary. This flap is commonly used for partial breast reconstruction following lumpectomy and for adding natural tissue to improve the result of a prior breast reconstruction.

(A) The TDAP flap is a perforator flap composed of skin and fat harvested from the upper back. The blood vessels that supply this flap are meticulously separated from the latissimus dorsi muscle so that muscle is not sacrificed and strength in the arm and shoulder are preserved. (B) The TDAP flap is rotated and “tunneled” under the skin from the back to the chest; microsurgery is not necessary. This flap is commonly used for partial breast reconstruction following lumpectomy and for adding natural tissue to improve the result of a prior breast reconstruction.

Frequently Asked Questions

Can I rely solely on a TDAP flap for full breast reconstruction?
TDAP flaps can sometimes be used to reconstruct the entire breast. For women who have sufficient tissue in their upper back, this option can be explored. In some cases, a combination of a TDAP flap and fat grafting can achieve excellent results.

How long will I stay in the hospital?
Most women can go home the same day as a TDAP procedure and recover at home without a hospital stay.

Is shoulder function affected by a TDAP flap?
Shoulder function should not be impacted for patients who undergo TDAP flap surgery. Because only skin and fat are included with these perforator flaps, the muscles and joints of the shoulder are not affected.

Will the scar be visible?
While any flap surgery leaves some form of sc ar, the scars that result from a TDAP flap procedure are designed to sit discretely under most clothing, and are therefore generally not visible except when one’s back is bare.

Explore All Perforator Flap Options

Not sure if the TDAP flap is the right choice for you? Our practice offers a range of perforator flap procedures and other reconstructive techniques to meet your individual needs.

View All Perforator Flap Procedures

We Are Here to Help

If you’re considering TDAP Flap Breast Reconstruction, our specialized team at TPRSG is here to guide you every step of the way. Contact us today to schedule a consultation and discover how this muscle-preserving approach may help you achieve a more natural and comfortable reconstruction.