Related Experiment Video
Updated: Apr 1, 2026
An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
Published on: December 5, 2025
The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction
Jordan Jacobs1, Mikkel Børsen-Koch, Gudjon Leifur Gunnarsson
1From the *Division of Plastic Surgery, Mount Sinai Medical System, New York, NY; †Department of Plastic Surgery, Vejle Hospital/Odense University Hospital, Denmark; ‡Department of Plastic Surgery, Telemark Hospital, Skien, Norway; §Department of Plastic Surgery, Herlev Hospital; and ∥Department of Plastic Surgery, Odense University Hospital, Denmark.
Background:
The thoracodorsal artery perforator (TAP) flap is a versatile tool that can be used to reconstruct the breast. The authors use preoperative perforator mapping using color Doppler ultrasonography and present a safe, efficient harvesting technique to demonstrate reliable use of the TAP flap in reconstructive surgery.
Methods:
A multicenter, retrospective review was performed on all patients undergoing TAP flap reconstruction from August 2011 to November 2014. Data were collected from patient records as well as outpatient interviews.
Results:
A total of 106 TAP flaps were performed in 97 patients. The flaps were raised with either 1 perforator (42/106), 2 perforators (55/106), or three perforators (9/106), and turned as a propeller in 99 of 106 (93%) flaps or buried as a turnover in 7 of 106 (7%) of flaps. The mean operative time was 200 minutes (range, 60-485). Major complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps.
Conclusions:
The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast reconstruction as well as breast conserving surgery. This large, multicenter series describes our techniques of preoperative perforator mapping and a fast, reliable harvest. Reconstructive goals are accomplished in the great majority of patients.
