ABSTRACT
We present the deep femoral artery perforator (DFAP) flap, a new perforator flap for
breast reconstruction, with a detailed description of operative technique and four
clinical examples. The DFAP flap allows harvest of tissue from the lower buttock and
lateral thigh with similar territory to an in-the-crease inferior gluteal artery perforator
(IGAP) flap but based on a different perforator. When present, the DFAP is the largest
vessel supplying this territory and is often septocutaneous, facilitating dissection
when compared with the IGAP flap. We used preoperative imaging with magnetic resonance
angiography to assist in accurate flap planning which also permitted precise determination
of perforator origin. In patients with either a contraindication to abdominal wall-based
perforator flaps or weight distribution below the waist, the DFAP flap provides an
alternative to the IGAP flap with an excellent pedicle and a favorable location on
the lateral thigh.
KEYWORDS
Perforator flap - microsurgical breast reconstruction
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Lisa F SchneiderM.D.
Department of Plastic Surgery, Institute of Reconstructive Plastic Surgery, New York
University Langone Medical Center
560 First Avenue, New York, NY 10016
Email: lisa.schneider@nyumc.org
