The Lumbar Artery Perforator flap (LAP flap) replaces the skin and soft tissue removed at mastectomy with tissue that is borrowed from the lower back. The incision will be over the lower back. With a LAP flap the skin, soft tissue, and very small blood vessels required to produce the breast reconstruction are removed from the lower back. In contract to the common flaps the blood vessels with the LAP flap are very short. Therefore, this also requires the use of additional blood vessels from the abdomen. A small incision will also be made in the lower abdomen to obtain these blood vessels. The blood vessels from the abdomen are connected to the blood vessels with the tissue from the back. This composite tissue is then transferred to recreate the breast.

Like other flap options the LAP flap can provide a contour improvement to the area that the tissue is removed from. This specifically means an improvement in the flanks and lower back. In some patients there is also he allusion of a buttock lift.

LAP flaps are a new and innovative flap. Dr. Haddock and his team are one of the few groups performing this surgery in the world. Dr. Haddock, and his team, is the only group with extensive experience in bilateral simultaneous LAP flaps. Most other centers do one side at a time. Dr. Haddock has performed over 3,000 breast reconstructions with flaps. His approach is focused on a few key goals including superior aesthetic results, limited abdominal morbidity, and operative efficiency leading to quicker recovery. When choosing a surgeon to perform this operation experience is key. Additionally, the focus of the operation can vary among surgeons. Dr. Haddock does not simply view success as flap survival but his goal is to achieve the result his patients desire.

Dr. Haddock typically performs these operations at UT Southwestern Clemens University Hospital in Dallas, Texas. Here he uses an Enhanced Recovery After Surgery (ERAS) Protocol to provide for faster recovery and limit postoperative discomfort..

As in all procedures, there are complications associated with autologous breast reconstruction. The potential adverse outcomes of autologous tissue breast reconstruction are total flap failure or partial flap failure. Total flap failure, the most feared complication, typically occurs due to a venous or arterial thrombosis of the vessels supplying the flap. With improved operative technique, in experienced hands this risk is extremely low. Patients may also experience hematomas, seromas and wound healing problems at the donor site or the recipient site.