title: Breast reconstruction with the profunda artery perforator flap.
abstract: BACKGROUND
  The use of perforator flaps has allowed for the transfer of large amounts of soft tissue with decreased morbidity. For breast reconstruction, the deep inferior epigastric perforator flap, the superior and inferior gluteal artery perforator flaps, and the transverse upper gracilis flap are all options. The authors present an alternative source using posterior thigh soft tissue based on profunda artery perforators, termed the profunda artery perforator flap.
  
  
  METHODS
  Preoperative imaging helps identify posterior thigh perforators from the profunda femoris artery. These are marked, and an elliptical skin paddle, approximately 27 × 7 cm, is designed 1 cm inferior to the gluteal crease. Dissection proceeds in a suprafascial plane until nearing the perforator, at which point subfascial dissection is performed. The flap has a long pedicle (approximately 7 to 13 cm), which allows more options when performing anastomosis at the recipient site. The long elliptical shape of the flap allows coning of the tissue to form a more natural breast shape.
  
  
  RESULTS
  All profunda artery perforator flaps have been successful. The donor site is well tolerated and scars have been hidden within the gluteal crease. Long-term follow-up is needed to evaluate for possible fat necrosis of the transferred tissue.
  
  
  CONCLUSIONS
  The authors present a new technique for breast reconstruction with a series of 27 flaps. This is an excellent option when the abdomen is not available because of the long pedicle, muscle preservation, ability to cone the tissue, and hidden scar.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: New York, N.Y.; and New Orleans, La. From the Department of Plastic Surgery, New York University Langone Medical Center, and the Division of Plastic Surgery, Louisiana State University Health Sciences Center.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Allen
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Haddock
authors.forename: Christina Y
authors.initials: CY
authors.lastname: Ahn
authors.forename: Alireza
authors.initials: A
authors.lastname: Sadeghi
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D004210:Dissection; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D013524:Surgical Flaps / Q000098:blood supply*