SGAP Breast Reconstruction

One option for flap breast reconstruction surgery after mastectomy is the gluteal technique, also known as the SGAP (superior gluteal artery perforator) or IGAP (inferior gluteal artery perforator). Because the buttocks contains “excess” skin and fat, it is considered by many to be the logical first choice for a tissue transfer. However, SGAP and IGAP procedures are among the most complicated of all microsurgical breast reconstruction techniques. This section discusses the details of gluteal flap reconstruction, as well as the pros and cons of SGAP and IGAP procedures.

What is SGAP and IGAP surgery?

SGAP and IGAP surgeries are techniques that transfer skin and fat from the buttocks to be used in the creation of a new breast mound following a mastectomy. The main difference between SGAP and IGAP is where the tissue is taken from. In SGAP, skin and fat is taken from the top (superior) area of the buttocks. In IGAP surgery, material is used from the lower (inferior) buttocks area, specifically the crease of the buttock, where the thigh and buttock meet.

Both forms of gluteal flap reconstruction are known as “free” flap microsurgeries. This means that the “flap” of skin and fat that is taken from the buttocks is completely detached from the donor site and original blood supply, and then connected to a new supply of blood vessels at the breast area. This is unlike TRAM flap and latissimus dorsi procedures which keep tissue connected to their original blood vessels. During SGAP or IGAP surgery, your surgeon will transfer skin and fat to the breast area, shape a natural-looking breast mound, and connect it to the appropriate blood vessels. Once this is complete, all incisions are closed and the recovery process begins.

Considerations for Gluteal Flap Patients

Gluteal flap surgery is an advanced breast reconstructive surgery technique that can help women regain their sense of beauty and self following breast removal. Some of the benefits of the SGAP and IGAP techniques include:

• No muscle removal- allows for faster healing
• Viable option for patients with little body fat in the abdomen or other areas
• High success rate
• IGAP scars are hidden
• Use of body’s own tissue decreases risk of complications or infection
• Tissue taken from buttocks resembles feel of natural breast

Some downsides to gluteal flap reconstruction include:

• Scarring at two surgical sites
• More recovery time than implant reconstruction
• Constricted blood flow to reconstructed breast

Many Patients Want to Know …

What is Recovery Like?

Each patient’s recovery process varies based on their individual condition. While “free flap” reconstructive procedures tend to require more recovery time than implant reconstruction, they have a distinct set of advantages as well. Most reconstructive surgery patients are fully physically recovered within 3-6 months. Learn more about breast reconstruction recovery.