Objective To explore the clinical application of thoradorsal artery perforator flaps (TAP) for reconstruction of breast defect and deformity. Methods From August 2007 to April 2014, 23 cases with breast defect and deformity were treated. TAP flaps were used in 18 cases for breast reconstruction and pre-expanded TAP flaps were used in 5 cases. The size of flaps ranged from 12 cm×22 cm to 7 cm×12 cm. Results All the flaps were survived. No complication was observed. All the patients were followed up for 3-26 months. The flaps were well healed with lowest donor site morbidity. Conclusion The thordorsal artery perforator flap is thin and reliable with long vascular pedicle and constant direction, and could provide a large area of skin flap after pre-expansion. It is an effective method for breast reconstruction.