PAP Flap

PAP Flap Phoenix, AZ

Patients who do not have enough donor tissue in the abdomen for a DIEP Flap may benefit from a PAP Flap autologous reconstruction – where donor tissue is borrowed from the inner thigh. This reconstruction technique uses skin, fat, and associated blood vessels from the back of the upper thigh to reconstruct the new breast(s). Since this technique is muscle-sparing, it results in faster recovery time and retained muscular strength in the donor site. PAP breast reconstruction is very popular with thin women, or women who already had abdominal surgery in the past.

Phoenix plastic surgeons Dr. Tessler and Dr. Turin use microsurgical techniques to remove tissue and blood vessels from the inner thighs and then use them to recreate the renewed, live tissue in the breast. The surgeon takes great care to preserve muscle and nerves in the donor area in order to ensure proper healing. Dr. Tessler and Dr. Turin take each patient as unique and develops a customized PAP reconstruction to suit their goals. He has helped many mastectomy patients from Phoenix, Scottsdale, Gilbert, and surrounding AZ cities feel whole again after battling breast cancer.

Am I a Candidate for PAP Reconstruction?

PAP flap is a type of breast reconstruction that uses the patient’s own tissue from the posterior thigh (right below the buttocks) to create a new breast after mastectomy. You may be an ideal candidate for this autologous reconstruction technique if you:

  • Desire a breast reconstruction using your own natural tissue
  • Have a slender body shape
  • Lack sufficient abdominal tissue to form a breast mound of the desired size
  • Have had prior abdominal surgery
  • Have experienced failure of a previous abdominal flap
  • Have experienced failure of a previous breast implant

During your breast reconstruction consultation with your surgeon, the surgeon will listen to your concerns, examine your body, and study your medical history before letting you know whether PAP reconstruction is for you. If your body type or medical history does not permit this procedure, Dr. Tessler and Dr. Turin will recommend an alternative autologous technique that suits your profile.


Benefits of PAP Flap Surgery

PAP flap breast reconstruction offers various unique benefits:

  • No implant complications – this is an autologous procedure where tissue from the patient’s own body is used to form the new breast shape. Patients do not have to deal with implant-related complications such as rippling, rupture, capsular contracture, or the need for multiple revision procedures to exchange the implants.
  • Muscle sparing – PAP Flap is a muscle-sparing autologous breast reconstruction technique. This results in a faster recovery with reduced morbidity in the donor site.
  • Well-hidden scar – the resulting scar from PAP Flap surgery is well concealed below the buttocks, where it is not easily noticeable.
  • Natural look and feel – since natural tissue from the patient’s own body is used – as opposed to artificial implants – PAP reconstruction results in a natural feeling and natural-looking outcome.

Drawbacks of PAP Surgery

Just like with any other surgical procedure, PAP reconstruction has a few drawbacks of its own:

  • Longer surgery time – this surgery takes a long time to complete because tissue has to be harvested from another area of the body and then used to form the new breast mound. This means patients will have multiple incision points and scarring (in the breast and thigh).
  • Risk of infection – the donor site can have some delayed healing, because of position in groin crease between the legs and friction. If there is delayed healing, it is usually treated with conservative wound care.

Dr. Tessler and Dr. Turin utilize advanced surgical techniques to deliver the best possible outcome while minimizing the risk of scarring and other complications. The surgeon will also provide antibiotic medication, and detailed instructions for incision care in order to reduce the risk of infection.


PAP Procedure Approach

PAP surgery is usually performed under general anesthesia at an accredited medical facility. During the surgery, your surgeon will create an incision in the back of your upper thigh, through which a triangular section of skin, fat, and blood vessels will be harvested and relocated to the chest. Dr. Tessler and Dr. Turin use microsurgery to re-attach the donor tissue blood supply to the chest breast supply. The removal of tissue from the upper thighs is essentially the same thing that would happen if the patient was receiving a thigh lift cosmetic procedure. Once the procedure is complete, the surgeon will close the incision sites in the upper thigh and the breast, and apply bandaging. PAP Flap is a lengthy procedure that takes about 4-7 hours to complete, based on the extensiveness of the treatment.

Recovery after PAP Flap Breast Reconstruction

Immediately after PAP surgery, the patient will be placed in a recovery room where the surgeon’s team will monitor vitals such as blood temperature, blood pressure, and heart rate. They will then be relocated to a hospital room where they need to stay for about 3 days before being discharged to go home. You will be required to wear a compression garment for up to 8 weeks. This is important because it helps control swelling and aids healing. Because you have had surgery at two (maybe even 4) separate sites, you might feel somewhat worse than a patient who had a mastectomy alone, and will probably take longer to recover. Dr. Tessler and Dr. Turin will provide precise instructions on how to care for your incision sites. Since pain and discomfort are common during recovery, the surgeon will provide pain medications, as well as antibiotics to prevent an infection. You will be restricted from engaging in any form of strenuous activities until after you get the go-ahead from the surgeon. Most of Dr. Tessler and Dr. Turin PAP surgery patients recover within 4-8 weeks, depending on the extensiveness of the surgery and their body’s unique healing ability.

Requirements After Surgery

After your PAP surgery in Scottsdale, Phoenix, Gilbert, Mesa, Paradise Valley, Glendale, or surrounding Arizona cities, Dr. Tessler and Dr. Turin will ask that you attend a number of post-operative visits that are important to monitor your recovery progress. The surgeon will use these visits to check your incision points, check for abnormalities, and generally assess your recovery progress. It is paramount that you attend all post-operative appointments and firmly adhere to Dr. Tessler and Dr. Turin’s recovery instructions in order to ensure speedy and optimal healing.

Insurance Coverage

The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires all group health insurance plans that pay for mastectomy to also cover all stages of breast reconstruction, including corrective procedures, insertion of prosthesis, as well as post-mastectomy lymphedema. Your health insurer should pay for breast reconstruction, whether it is done at the same time as the mastectomy/lumpectomy, or years later. This includes reconstruction procedures that may be needed over time to improve the reconstructed breast or create a balance between the two breasts. Keep in mind though that government and church-sponsored plans are not always required to cover reconstruction, so you may need to check with your insurance provider.

Average Cost

Varies per patient

Recovery Time

Up to 8 weeks

Procedure Time

4-7 hours, hospital stay for 3 days



Schedule your PAP Breast Reconstruction Procedure in AZ

Working with a highly experienced, board-certified plastic surgeon is the first step towards ensuring a successful breast reconstruction procedure. Dr. Tessler was appointed assistant and associate professor of Plastic Surgery at Louisiana State University and Tulane University. He has also served as Director of Plastic Surgery at University Medical Center, as well as contributed important research in the field and trained dozens of the upcoming plastic surgeons. Dr. Tessler’s passion lies in restoring form and function while improving the quality of life of his patients. He brings a friendly and personalized approach to reconstruction surgery while working with highly qualified anesthesiologists and other support staff who strive to deliver the best PAP Flap surgery Phoenix, AZ has to offer. Get in touch with Tessler Plastic Surgery to schedule your first appointment today.