The superior gluteal artery perforator SGAP flap uses tissue from the top of the buttocks to create breast tissue. This is usually done if patients do not have adequate skin and tissue in their abdomens, or have had previous abdominal surgeries that may have interfered with blood vessels that the DIEP flap requires. This flap procedure does not take tissue from the central area of the buttock, thereby lifting the lateral thigh and buttock area while preserving the natural contours.
The photographs included on this page are the results of reconstructive procedures performed by the surgeons at the Center for Restorative Breast Surgery. GAP stands for gluteal artery perforator, a blood vessel that runs through your buttocks. Because no muscle is used, an SGAP flap is considered a muscle-sparing type of flap.
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Perforator flaps have revolutionized the field of reconstructive plastic surgery by allowing novel therapeutic options with minimal functional cost to the patient. Despite initial resistance, perforator flaps are now preferentially accepted as the gold standard in autogenous reconstruction in situations where muscle transfer is not necessary. The superior gluteal artery perforator SGAP flap constitutes the descendant of the gluteus maximus myocutaneous flap. Although possessing all of its predecessor's advantages, the SGAP flap generates much less donor-site morbidity.
Breast reconstruction using your own tissue without the use of implants is called autologous referring to your own tissue flap surgery. Not every woman is a candidate for this type of breast reconstruction, and it is best to discuss the pros and cons of these procedures with your surgeon. SGAP superior gluteal artery perforator flap procedure uses fat and skin from your upper buttock to create a new breast mound after a mastectomy.
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The SGAP flap has been primarily used as an alternate for breast reconstruction, and requires significant microsurgical experience to harvest. The thickness of fat available provides volume for unilateral reconstruction, but positioning and the donor scar deformity have made this a less popular choice even among very experienced microsurgeons. The superior gluteal artery and venae arise from the internal iliac system deep in the pelvis.
Breast reconstruction is a surgical procedure that restores shape to your breast after a mastectomy — surgery that removes your breast to treat or prevent breast cancer. Breast reconstruction with flap surgery involves taking a section of tissue from one area of your body — most often your abdomen — and relocating it to create a new breast mound. Breast reconstruction with flap surgery is a complex procedure performed by a plastic surgeon. Much of the breast reconstruction using your body's own tissue can be accomplished at the time of your mastectomy immediate reconstructionthough sometimes it can be done as a separate procedure later delayed reconstruction.
This is an excellent option for women who do not have enough tissue in the abdomen for undergoing breast reconstruction. In these circumstances, we can use an excess fat and skin from the top or bottom of buttocks. Most patients are good candidates for undergoing breast reconstruction using the top of the buttocks SGAP. Depending on the distribution of fat in the buttocks we will use the top, SGAP flap, vascularized with the superior gluteal artery, which brings together an adequate tissue for our reconstruction and lifting effect elevation of the buttocks.