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Mytien Goldberg, MD, FACS

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What Is a “Love Handle” Flap or Lumbar Artery Perforator (LAP) Flap in Breast Reconstruction?

Posted March 19, 2022 in Breast Reconstruction

4 Minute Read:

The commonly known love handle flap — also called the lumbar artery perforator flap (LAP) — is composed of fat and skin with its own blood supply, nourished by the lumbar artery perforator. This flap is harvested from the lower back or flank region, just below the bikini or undergarment line. 

Among its benefits, harvesting the fat and skin in this region will improve the waistline. 

Illustration of the latissimus dorsi flap

The love handle flap or LAP flap is a great flap option for breast reconstruction in patients who previously had a tummy tuck where the DIEP flap is no longer an option. 

Dr. Goldberg also uses the LAP flap in patients who have had a failed DIEP flap in the past or patients who’ve had a previous tummy tuck or major abdominal surgery, whereby the blood supply to the DIEP flap skin territory was injured. 

What Are the Benefits of the Love Handle or LAP Flap?

Harvesting the love handle flap will result in a scar that sits in the crease of your lower back. It yields a slimmer waistline and removes the muffin top that most women desire to be removed anyway. It also lifts the buttocks, creating a firmer and lifted backside. 

Woman's back to show area of latissimus dorsi flap

In summary, the LAP flap will create: 

  • Scar on the lower back
  • Slimmer waistline and silhouette of the lower back
  • Lifted buttock 
  • All-natural tissue breast reconstruction 

Who Are the Candidates for the Love Handle or LAP Flap? 

The “love handle” or the LAP flap is a great option for autologous breast reconstruction in women with skin laxity and fat deposit in their flanks and those who had previous major abdominal surgery whereby the blood supply to the DIEP flap region was injured. 

Furthermore, LAP flap is also a great option in patients who have had a previous tummy tuck and in patients who have a failed attempt of DIEP flap in the past. 

In patients with a BRCA gene mutation (who are often young and have minimal laxity of the lower abdominal tissue), the LAP flap is an excellent reconstructive option. 

What Are the Disadvantages of the Love Handle or LAP Flap? 

The nourishing blood supply to the LAP flap is short and of a smaller caliber than that of the DIEP flap. Thus, a vein and artery graft may be needed to achieve the adequate length and caliber needed for the reconstruction. 

Envision the vein and artery graft as an extension cord for the flap. Furthermore, changes in surgical positioning of the patient is required during the harvesting and in-setting of the flap. Therefore, the surgery can take longer than the typical DIEP flap procedure. 

Overall, a recent study examining the satisfaction rate of women undergoing breast reconstruction using LAP flap showed a high satisfaction rate using the breast Q questionnaire as a measuring tool. 

Furthermore, these patients would undergo the same surgery if given the choice and would recommend it to other women as an option for breast reconstruction. 

Interested in Learning More?

Dr. Mytien Goldberg is a leading female plastic surgeon in Beverly Hills, specializing in breast reconstruction and breast reconstruction revision. Recognized by her peers as one of the most skilled microsurgeons, she is also known for her attention to detail, high-caliber surgical skills and beautiful, natural results. 

For women seeking breast reconstruction or breast reconstruction revision, Dr. Goldberg offers a wide spectrum of flap reconstruction using different parts of your body to recreate natural breasts, including DIEP, SGAP, PAP, LAP, LTP flaps, and hybrid reconstructions. She has been in practice for over 10 years and is a faculty member with the division of plastic surgery at UCLA David Geffen School of medicine. She was awarded the teacher of the year by UCLA chief residents for her mentorship and teaching. 

If you have recently been diagnosed with breast cancer and are looking for a plastic surgeon to perform your breast reconstruction, Dr. Goldberg is your plastic surgeon. 

And if you have had breast cancer and are dissatisfied with your reconstruction results, the first step is to schedule a comprehensive in-office or video consultation with Dr. Goldberg. After the exam, Dr. Goldberg can create an individualized plan to address your specific concerns and answer any questions you may have.

For many women in southern California and around the country, Dr. Mytien Goldberg is the plastic surgeon of choice for breast reconstruction, revision, and correction procedures.

Contact us today to learn more.


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