[Breast reconstruction with Profunda Artery Perforator flap in lithotomy position. Surgical technique]

Autologous breast reconstruction provides great cosmetic, functional and sustainable incomes. Various flaps have been described in autologous breast reconstruction, Deep Inferior Epigastric Perforator flap (DIEP) being the most frequent. For patients with a non-sufficient abdomen for a DIEP based breast reconstruction, the Profunda Artery Perforator Flap (PAP), based on profunda arteris perforators, is a current trend, but few publications detailed the flap harvest. Comparing with a TUG flap, the morbidity linked to the muscle harvest is decreased. Usually the dissection is done in prone or in "frog leg" position. The aim is to describe a technical option: we propose a different position, with a harvest of the PAP in lithotomy position. It offers additional comfort and security for the surgeon and decreases the operative time. The pedicle had an average of 7cm in length; the artery diameter was 2.2mm and the vein 2.5mm. The cosmetic incomes are very good six months postoperative.