The SGAP, or Superior Gluteal Artery Perforator Flap, was developed by Dr. Robert Allen in 1993. We were also the first to perform the bilateral simultaneous SGAP in 1994, and our experience has subsequently been published.
This is an excellent option for 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.
Which buttock donor site to chose is a matter of preference and anatomy. Both the IGAP and the SGAP can be used for unilateral or bilateral simultaneous reconstruction.
The In-The-Crease IGAP (Inferior Gluteal Artery Perforator) Free Flap
Our newest development, the In-The-Crease I-GAP Flap, is an excellent option for many women. Excess skin and fat are borrowed from the inferior buttock, leaving an improvement in buttock shape, and a scar that is almost completely hidden. For women requiring bilateral reconstruction both the SGAP and the IGAP can be performed as a bilateral simultaneous operation, so that only one operation is needed to reconstruct both breasts.
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