One reconstructive option to consider is having a new breast constructed using your tissue. Your tissue can be used to construct a new breast using one of several leading-edge breast reconstruction procedures. Using tissue from the buttock in the form of GAP flaps, we will avoid damaging important muscles. The result is faster recovery time and a more natural-looking result.

GAP stands for “Gluteal Artery Perforator”—a blood vessel that runs through your buttocks. A GAP flap uses this blood vessel, as well as a section of skin and fat from your buttocks (from the “love handles” on the hips, or near the buttock crease), to reconstruct the breast. Because no muscle is used, a GAP flap is considered a muscle-sparing breast flap.

There are two types of GAP flaps: 

  • SGAP (superior gluteal artery perforator) flap
  • IGAP (inferior gluteal artery perforator) flap

The gluteal artery has two sections: one more toward the top of your buttocks (the superior gluteal artery perforator), used for the SGAP, and one more toward the bottom of your buttocks, near the buttock crease (inferior gluteal artery perforator), used for the IGAP. This portion of the gluteal artery used is the only difference between the two GAP flaps.

In GAP flap breast reconstruction procedures, fat, skin, and blood vessels are removed from your buttocks and moved to your chest to rebuild your breast(s). We carefully reattach the blood vessels of the flap to blood vessels in your chest using microsurgery.

Because skin and fat are moved from the buttocks to the chest, having either type of GAP flap can mean that your buttocks will be lifted —as if you have had a buttock lift. The SGAP flap leaves a scar near the top of your hips, but it’s almost always covered by a bikini bottom or underwear. The IGAP flap scar is hidden in the crease of your buttocks.

Because this procedure is performed in the prone position, this surgery can take longer to perform when compared to the procedures performed in the supine position (PAP or DIEP flaps). An SGAP flap or an IGAP flap is a good choice for thin women who don’t have enough extra belly tissue. Prior to surgery, imaging studies such as CT scans or MRI scans are performed to localize the best blood vessels from the gluteal region to shorten the operative time of this procedure.