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IGAP and SGAP Flap Breast Reconstruction

GAP stands for gluteal artery perforator, a key blood vessel running through the buttocks. GAP flap procedures use this vessel along with skin and fat from the buttock area to reconstruct the breast after mastectomy. These techniques are ideal for women who don’t have enough abdominal tissue for reconstruction or who have had prior abdominal surgeries.

Types of GAP Flap Procedures

SGAP (Superior Gluteal Artery Perforator) Flap

This technique uses fat and skin from the upper buttocks (near the hip) along with the superior gluteal artery. The tissue is carefully transferred and reconnected to blood vessels in the chest using microsurgery. The scar is placed near the top of the buttocks and is usually hidden under underwear.

IGAP (Inferior Gluteal Artery Perforator) Flap

Similar to SGAP, the IGAP flap uses tissue from the lower buttocks, near the crease. Because this area includes the sitting bone (ischium), the procedure may cause temporary numbness and carries a small risk of pressure sores. For this reason, it’s used less frequently than SGAP.

Who Might Be a Good Candidate

You may be a good fit for SGAP or IGAP flap reconstruction if:

  • You’ve had a double mastectomy and need tissue for both breasts.
  • You lack sufficient abdominal tissue or can’t use it due to past surgeries.

These methods may not be ideal if:

  • Preserving the natural shape of your buttocks is important to you.
  • You’ve had prior liposuction in the buttocks or hips, limiting usable tissue.

Important Considerations

SGAP and IGAP procedures are more complex than other flap surgeries and require specialized microsurgical expertise. When reconstructing both breasts using SGAP or IGAP flaps, some surgeons prefer to stage the surgeries a few months apart. However, it’s possible to have both done at once with two surgeons operating simultaneously, as this approach minimizes recovery time but requires a well-coordinated team.

What to Expect From Surgery

These are muscle-sparing procedures, meaning no muscles are removed — just skin, fat, and connecting blood vessels. After surgery, many patients report that their buttocks feel firmer, similar to the effect of a cosmetic butt lift. The SGAP scar runs along the upper buttocks and is typically hidden by underwear. The IGAP scar lies in the crease at the bottom of the buttocks and is generally discreet.

While less common than abdominal-based flaps, SGAP and IGAP procedures offer excellent options for women seeking natural reconstruction when other donor sites aren’t viable.

Your journey starts here. Please get in touch with us by filling out an online form or calling 1-883-RENEWBR.