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Women who do not have an adequate amount of abdominal tissue for a DIEP flap or SIEA flap reconstruction may be candidates for GAP (gluteal artery perforator) flap breast reconstruction. This procedure uses excess skin and fat from the gluteal (buttock) region and leaves all the gluteal muscle behind. Sparing the muscle preserves function and makes recovery easier.
Your surgeon may take skin and fat from either your upper ("superior") or lower ("inferior") buttock region. These are referred to as the "sGAP" or "iGAP" flap respectively. Both incisions are easily hidden with most underwear or bathing suits. As with any breast reconstruction method, the procedure can be performed as an immediate or delayed reconstruction.
Patients undergoing bilateral GAP reconstruction may have only one breast reconstructed at a time. Many surgeons prefer to use this staged approach to minimize the risks of the procedure. It is important to discuss this possibility with your surgeon since it would require you to undergo an additional surgery.