Lateral Thigh Perforator Flap in Breast Reconstruction

  • Stefania TuinderEmail author
  • Ennie Bijkerk
  • Jop Beugels
  • René van der Hulst
  • Marc Lobbes
  • Arno Lataster


This chapter will discuss the lateral thigh perforator (LTP) flap for the use in breast reconstructive surgery. The LTP is an alternative flap for those patients in whom the first choice donor site, the abdomen, is not suitable as a do nor site. The history of the LTP flap, also known as the septocutaneous perforator tensor fasciae latae (TFL) flap, is described. Knowledge of the topographical and functional anatomy of the thigh is crucial for a surgeon when harvesting the LTP flap. Preoperative radiological imaging is essential in selecting suitable patients and planning the surgical procedure, which is systematically explained in the paragraph “Surgical Technique.” The authors share their experience and provide the reader with tips to perform a LTP flap breast reconstruction.


Autologous Breast reconstruction Microsurgery Breast cancer Perforator flaps Lateral thigh perforator 



We would like to thank Greet Mommen, medical scientific illustrator at Maastricht University, Department of Anatomy and Embryology, for the realization of the illustrations in this chapter. Her ideas and active contribution were essential to help clarify and visualize the concepts as described above. We also would like to thank Paul van Dijk, histologic technician at the same department, for the excellent photography of the cadaveric dissection.

Supplementary material

Video 25.1

Demonstration of the surgical technique of the lateral thigh perforator flap breast reconstruction and its additional procedures (MP4 121904 kb)


  1. 1.
    Allen RJ, Treece P. Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg. 1994;32(1):32–8.CrossRefGoogle Scholar
  2. 2.
    Healy C, Allen RJ Sr. The evolution of perforator flap breast reconstruction: twenty years after the first DIEP flap. J Reconstr Microsurg. 2014;30(2):121–5. Scholar
  3. 3.
    Levine J, Vasile J, Chen C, Allen RS. Perforator flaps for breast reconstruction. New York: Thieme Medical; 2016.CrossRefGoogle Scholar
  4. 4.
    Tuinder S, Lataster A, van Der Hulst R. Lateral thigh perforator flap (septocutaneous tensor fascia latae perforator flap). In: Levine J, Vasile J, Chen C, Allen Sr R, editors. Perforator flaps for breast reconstruction. New York: Thieme Medical; 2016. p. 114–21.Google Scholar
  5. 5.
    Elliott LF, Beegle PH, Hartrampf CR Jr. The lateral transverse thigh free flap: an alternative for autogenous-tissue breast reconstruction. Plast Reconstr Surg. 1990;85(2):169–78; discussion 179-181CrossRefGoogle Scholar
  6. 6.
    Mackenzie K. The repair of large abdominal herniae by muscle transplantation. Br J Plast Surg. 1924;12:28–30.Google Scholar
  7. 7.
    Hill HL, Nahai F, Vasconez LO. The tensor fascia lata myocutaneous free flap. Plast Reconstr Surg. 1978;61(4):517–22.CrossRefGoogle Scholar
  8. 8.
    Nahai F, Silverton JS, Hill HL, Vasconez LO. The tensor fascia lata musculocutaneous flap. Ann Plast Surg. 1978;1(4):372–9.CrossRefGoogle Scholar
  9. 9.
    Kind GM, Foster RD. Breast reconstruction using the lateral femoral circumflex artery perforator flap. J Reconstr Microsurg. 2011;27(7):427–32. Scholar
  10. 10.
    Hubmer MG, Schwaiger N, Windisch G, Feigl G, Koch H, Haas FM, Justich I, Scharnagl E. The vascular anatomy of the tensor fasciae latae perforator flap. Plast Reconstr Surg. 2009;124(1):181–9. Scholar
  11. 11.
    Maricevich MA, Bykowski MR, Schusterman MA 2nd, Katzel EB, Gimbel ML. Lateral thigh perforator flap for breast reconstruction: computed tomographic angiography analysis and clinical series. J Plast Reconstr Aesthet Surg. 2017;70(5):577–84. Scholar
  12. 12.
    Vegas MR, Martin-Hervas C. The superolateral thigh flap: cadaver and computed tomographic angiography studies with a clinical series. Plast Reconstr Surg. 2013;131(2):310–22. Scholar
  13. 13.
    Tuinder S, Baetens T, De Haan MW, Piatkowski de Grzymala A, Booi AD, Van Der Hulst R, Lataster A. Septocutaneous tensor fasciae latae perforator flap for breast reconstruction: radiological considerations and clinical cases. J Plast Reconstr Aesthet Surg. 2014;67(9):1248–56. Scholar
  14. 14.
    Grob K, Manestar M, Ackland T, Filgueira L, Kuster MS. Potential risk to the superior gluteal nerve during the anterior approach to the hip joint: an anatomical study. J Bone Joint Surg Am. 2015;97(17):1426–31. Scholar
  15. 15.
    Lakhiani C, Lee MR, Saint-Cyr M. Vascular anatomy of the anterolateral thigh flap: a systematic review. Plast Reconstr Surg. 2012;130(6):1254–68. Scholar
  16. 16.
    Tuinder SMH, Beugels J, Lataster A, de Haan MW, Piatkowski A, Saint-Cyr M, van der Hulst R, Allen RJ. The lateral thigh perforator flap for autologous breast reconstruction: a prospective analysis of 138 flaps. Plast Reconstr Surg. 2018;141(2):257–68. Scholar
  17. 17.
    Saadeh FA, Haikal FA, Abdel-Hamid FA. Blood supply of the tensor fasciae latae muscle. Clin Anat. 1998;11(4):236–8.<236::AID-CA2>3.0.CO;2-P.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Stefania Tuinder
    • 1
    Email author
  • Ennie Bijkerk
    • 1
  • Jop Beugels
    • 1
  • René van der Hulst
    • 1
  • Marc Lobbes
    • 2
  • Arno Lataster
    • 3
  1. 1.Department of Plastic and Reconstructive SurgeryMaastricht University Medical CenterMaastrichtThe Netherlands
  2. 2.Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
  3. 3.Department of Anatomy and EmbryologyMaastricht UniversityMaastrichtThe Netherlands

Personalised recommendations