Autologous breast reconstruction is the standard approach to reconstruct a natural looking breast. The DIEP flap is the cornerstone flap to provide an ample amount of tissue that can be taken to reconstruct the breast. However, it often occurs that the abdominal tissue is not available due to previous surgery or tissue deficiency. In those cases, alternative flaps have been used, each with their specific advantages and drawbacks.

Our second choice for autologous breast reconstruction is the lumbar artery perforator flap (LAP flap) due to its numerous advantages. We have utilized the LAP flap as a secondary option for breast reconstruction. Our experience indicates that this flap significantly enhances our armamentarium in autologous breast reconstruction.

The LAP flap offers several advantages in autologous breast reconstruction: a consistent anatomy, an excellent shape and contour for the reconstructed breast, and the potential to restore breast sensation. However, the drawbacks include a learning curve and the necessity for microsurgical expertise.