Efficacy of the Posterior Accessory Saphenous Vein as a Vein Graft in Breast Reconstruction Using Profunda Artery Perforator Flap.

The profunda artery perforator (PAP) flap, commonly used for small- to medium-sized breast reconstructions, offers easy harvest and inconspicuous donor-site scars. However, its shorter vascular pedicle compared with the deep inferior epigastric perforator flap limits its reach to lateral recipient vessels. This often requires strategic placement of perforators at the flap's edge to extend reach, potentially causing congestion in the distal part of the flap.