Summary
The abdomen or inner thighs are often the most common and preferred donor areas for patients who would like breast reconstruction using their own tissue. However, those areas are not always the best option for every patient. In some situations, using tissue from the back or buttocks makes more sense, especially if that is where you naturally carry extra tissue.
When is a back flap a good option?
A flap from the back can be especially helpful if:
- You have had problems with healing after implant reconstruction
- You need reconstruction of part of the breast after a lumpectomy
- You have extra tissue on your back but not enough tissue on your abdomen or thighs
- Prior surgeries or body shape make abdominal or thigh flaps less ideal
What is a back flap?
Back flaps are commonly called latissimus dorsi or TDaP (thoracodorsal artery perforator) flaps.
- A latissimus dorsi flap uses skin, fat, and muscle from the upper back.
- A TDaP flap uses skin and fat but preserves the back muscle.
Your surgeon will recommend the option that best fits your reconstructive needs. In some cases, part or all of the back muscle may be used. Even when the entire muscle is included, most patients do not notice a meaningful loss of arm or shoulder strength in daily life.
Sometimes, a back flap can be combined with fat grafting (transferring fat from another part of your body) to create enough volume without needing an implant.
What about back flap scars?
The scar location can vary based on your body shape and your preferences. It can be:
- Hidden along the bra line
- Placed diagonally to blend into natural skin folds
- Positioned along the side of the body to be less noticeable in open-back clothing
Your surgeon will discuss the options with you to find the approach that fits your goals.
Do back flaps require microsurgery?
Back flaps are usually “pedicled,” which means the tissue stays connected to its original blood supply and is moved to the chest through a tunnel under the skin. Because the blood vessels stay attached, microsurgery (sewing blood vessels together under a microscope) is typically not required.
When is a buttock flap a good option?
A flap from the buttock can be especially helpful if:
- You have extra tissue on your buttock but not enough tissue on your abdomen or thighs
- Prior surgeries or body shape make abdominal or thigh flaps less ideal
What is a buttock flap?
Buttock flaps are commonly called SGAP (superior gluteal artery perforator) flaps. This flap uses excess skin and fat along the upper buttock, but preserves the buttock muscle.
What about buttock flap scars?
The scar location can vary based on your body shape and your preferences. It typically is along the upper/outer buttock and maintains good buttock contour.