IGAP and SGAP Flap MethodsAn IGAP breast reconstruction is very similar to the SGAP procedure, and differs in only one way: IGAP uses tissue taken from your lower buttock, SGAP uses tissue from your upper buttock. Both are free flap reconstructions that use microsurgery to reconnect an artery from your tissue flap to your chest area to create a breast mound. Most women have enough tissue on their buttocks to create a new breast, but if there is not enough tissue, a small implant can be tucked behind your tissue flap to help fill out the size of your new breast. The removal of skin and fat from your buttock is similar to the procedure for a buttock lift, but includes an artery and vein that will supply blood to the transplanted tissue.
Advantages and Disadvantages of IGAPPros:
- good option if you don't have ample tummy fat
- good option for anyone who has enough skin and fat on the lower buttock
- no muscle is cut or moved, speeding recovery time
- buttock lift results from gluteal skin and fat removal
- less than 2% failure rate
- two scars result, because of two surgery sites
- if your IGAP fails, the tissue flap may die, and will have to be completely removed
- if your reconstruction fails, you must wait 6 - 12 months to try again
You're Not a Candidate for an IGAP If:
- you have previously had lower buttock skin and fat removed
- you have had liposuction on your lower buttock
- you smoke – your buttock scar will take a long time to heal, and your fat tissue is more apt to develop into scar tissue
What to Expect During a IGAP Flap Breast Reconstruction
Moving Fat, Skin and Blood Supply
Closing the IGAP Flap Incision
Creating Your New Breast
Recovering from IGAP Flap Breast ReconstructionPlan on wearing loose, comfortable clothing for the next few weeks. Tight jeans over a buttock incision with drains will be uncomfortable. You should plan on staying in the hospital for three or four days after this surgery, and expect to have nurses keeping an eye on your healing process. About a week after surgery, if your fluid buildup has significantly decreased, you may be able to have your drains removed. You'll have to rest four to six weeks after a IGAP, so make sure someone will be around to do driving and lifting for you.
IGAP Flap for Double MastectomyIf you have enough skin and fat on both buttocks to create two new breasts, you can have a bilateral simultaneous IGAP flap reconstruction after a double mastectomy. If you've already had buttock tissue used for breast reconstruction (SGAP flap) then you must choose a different method (DIEP, lat flap or implant).
Special Considerations About the IGAP FlapThe IGAP uses buttock tissue that has a contour similar to the contour of your natural breast, so many plastic surgeons think it results in a better breast reconstruction than an SGAP procedure. IGAP flap is microsurgery, which requires extensive training, skill and experience, in addition to special facilities at your hospital. The sutures used to reconnect the blood vessels are about the same diameter as a strand of your hair. Your surgical team will be using special tools and a high-power microscope to perform the most critical part of this procedure. Choose a surgeon for this reconstruction carefully -- ask plenty of questions until you feel good about your decision.
Sources: National Cancer Institute. Surgery Choices for Women with Early-Stage Breast Cancer. Posted 10/22/2004. Breast reconstruction with gluteal artery perforator flaps Jay W. Granzow, Joshua L. Levine, Ernest S. Chiu, Robert J. Allen Journal of Plastic, Reconstructive & Aesthetic Surgery - June 2006 (Vol. 59, Issue 6, Pages 614-621, DOI: 10.1016/j.bjps.2006.01.005)
American Cancer Society. Breast Reconstruction After Mastectomy. Types of Breast Reconstruction. Revised: 09/06/2007.
National Cancer Institute. Surgery Choices for Women with Early-Stage Breast Cancer. Posted 10/22/2004.
Breast reconstruction with gluteal artery perforator flaps Jay W. Granzow, Joshua L. Levine, Ernest S. Chiu, Robert J. Allen Journal of Plastic, Reconstructive & Aesthetic Surgery - June 2006 (Vol. 59, Issue 6, Pages 614-621, DOI: 10.1016/j.bjps.2006.01.005)