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Superior and Inferior Gluteal Artery Perforator Flap (SGAP and IGAP)

For those without adequate abdominal tissue, other areas can be borrowed from without disturbing the body's underlying muscle structure. These are options for thinner women who do not have ample abdominal tissue to donate for breast reconstruction or for those who would prefer to use the upper buttock as a donor site.

Almost all patients are candidates for use of the upper buttock (the SGAP) for breast reconstruction. This donor site can be used for unilateral or bilateral simultaneous reconstructions. This donor site differs from the IGAP in its position on the buttock, the resulting scar placement and the blood vessel used to supply the tissue.

For the SGAP it is the superior (upper) gluteal artery, and for the IGAP it is the inferior (lower) gluteal artery. The SGAP scar lies in the upper buttock and is easily hidden in a French cut bikini or in underwear. The IGAP scar lies within the lower buttock crease. Otherwise these donor sites are comparable in terms of the reconstruction they provide.

Before & After (SGAP)

Autogenous augmentation with GAP flaps to correct severe capsular contracture from implant augmentation.

SGAP Before Surgery

SGAP After Surgery

Before

After

Before and After (IGAP)

Breast Asymmetry Before IGAP

Patient Donor Site Before IGAP

Asymmetry following right lumpectomy and radiation

Donor site of Patient

Breast Reconstruction 3 Months After IGAP

Patient Donor Site 3 Months After IGAP

Three months following right partial breast reconstruction and left breast augmentation with TUBA (transumbilical [through the belly button] breast augmentation.)

Donor site of Patient Three Months after Surgery

photos courtesy of www.joshualevinemd.com

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