Stacked PAP Flaps for Two-Stage Immediate Bilateral Breast Reconstruction: A Case Report

Although abdominal tissue remains the gold standard in autologous breast reconstruction,1 other donor sites like buttocks, thigh, dorsal area are often used. The posterior thigh flap was first described in 1980 by Hurwitz and posteriorly transferred as a free flap by Song et al. in 1984. Pap flap has gained popularity, as it offers a favorable response based on a consistent vascular anatomy, ease of harvest, and low morbidity profile,2 being considered, as an excellent alternative to the anterolateral thigh perforator flap for head and neck and limb reconstruction. Today, it is increasingly used for autologous breast reconstruction. The ideal patient for the latter has a breast of small to moderate size, with previous surgery or limited donor tissue on the abdominal area.