Since 1994, free DIEAP flap has remained the gold standard for breast reconstruction due to similarity of its appearance and texture with breast. Important aspects are long-term results of reconstruction and minimal changes over time. In addition, this flap is the most accurate option for breast reconstruction regarding donor site damage. Despite widespread application, certain contraindications such as previous surgeries, cicatricial deformity and soft tissue deficiency in anterior abdominal wall call into question the use of this donor area. In some cases, we are faced with situation not allowing any possible standard option for breast reconstruction due to the patients’ reluctance/fear of foreign body or consequences of radiotherapy. Alternative flaps may be considered in these cases: SGAP (Superior Gluteal Artery Perforator) flap or IGAP (Inferior Gluteal Artery Perforator) flap and PAP (Profunda Artery Perforator) flap; latissimus dorsi flap. The main problems are technical complexity and/or significant donor site damage. In this regard, searching for alternative options for breast reconstruction remains relevant. In this article, we present non-standard bilateral breast reconstruction using LAP (Lumbar Artery Perforator) flap. In national literature, we found no reports devoted to lumbar artery perforator flaps for breast reconstruction with autologous tissues. To date, it is the first similar surgery in Russia.

Keywords. breast reconstruction, LAP flap, microsurgery