Summary
The TAP (TDAP) flap moves tissue from the upper back to the chest. This approach is typically pedicled, meaning that the blood supply from the back remains connected to the back. The skin and fat is isolated and then rotated from the back toward the front of the breast.
TAP (TDAP) flap includes skin from the back used to reconstruct a lumpectomy defect (upper 3 images). Skin from the flap replaces missing lower breast tissue, and the back donor site is repaired (lower 2 images).
This flap is a good option for partial reconstruction, which helps even out or otherwise improve contour after a lumpectomy. It may provide enough tissue to reconstruct a whole breast in patients with small breasts. The TAP (TDAP) flap is sometimes used in hybrid reconstruction that combines it with an implant to add volume.
Procedure Details:
- Surgeons elevate skin and fat from the back without repositioning any muscle
- Perforator vessels that pierce through the LD muscle on the back are exposed
- The flap and blood vessels are rotated from the back to the chest. The blood vessels remain attached to the back
- The flap tissue is used to restore breast contour.
Risks & Benefits
In most cases, the TAP (TDAP) flap can only provide a relatively small amount of tissue. This limits the volume available for reconstructive use. Its limited volume means that it is best suited for partial breast reconstruction or reconstruction after lumpectomy.
The recovery for this flap, which preserves the latissimus muscle, tends to be easier than the recovery associated with a flap that moves that muscle.