We specialize in state-of-the-art breast reconstruction techniques using your body’s own tissue without sacrificing important functional muscles.

Considered the most advanced in the world today, our procedures result in a breast that closely matches your own in shape and softness.

IGAP and SGAP – Breast Reconstruction using Your Gluteal Region

For patients where the abdomen or thigh does not provide sufficient tissue, the gluteal region or buttock can also be used.  On the buttock the upper portion or the lower portion may be used. The upper portion is referred to as the Superior Gluteal Artery Perforator flap (SGAP flap) and the lower portion is referred to as the Inferior Gluteal Artery Perforator flap (IGAP flap). Both the IGAP and SGAP procedures use tissue only from the gluteal region or buttock. The choice between which flap to use is based on the best location of excess fat on the specific patients buttock region.  In general the IGAP is the slightly preferred choice, because the scar is lower – approximately one inch above the gluteal fold.

Once the tissue is safely detached from the buttock, the donor site on the buttock is closed, and harvested buttock tissue is reattached to the small blood vessels in the breast area. A small piece of cartilage on the third or fourth rib is removed to allow access to the blood vessels in your breast area. The tiny blood on the buttock tissue are then connected to small blood vessels in the breast  using microsurgery techniques, similar to the techniques used for all other microsurgical free tissue transfers. Once this is complete, the blood flow to the tissue is restored. Next, the tissue is shaped to fit the mastectomy defect.

The scar on the buttock and the potential need for a symmetry operation on the opposite buttock reduces its appeal. This technique also requires a longer operation and mores surgical skill. It has a slightly higher failure rate then tissue transfers from the abdomen inner thigh or back.