T. 07540 549 873 E. info@londonbreast.co.uk

Although the DIEP flap is generally the first choice for perforator-flap breast reconstruction, not all women are candidates for a perforator flap harvested from the abdomen.

In addition, some women may simply prefer to have a reconstruction using a donor site other than the abdomen. Some extremely slender women may have little abdominal tissue to reconstruct a breast of the desired size, while others may have previously undergone specific abdominal surgery that precludes the use of an abdominal perforator flap (for example, a tummy tuck).


With GAP flaps, tissue for breast reconstruction can be harvested from either the upper or lower buttock, depending upon body shape and personal preference. Skin and soft tissue can be harvested from the buttock region using an incision that will be concealed in most clothing, possibly even in some bikinis. The blood vessels needed for either an SGAP or IGAP flap are meticulously separated from the gluteus maximus muscles in which they travel without removing any muscle.

  • SGAP Flap (upper buttock):
The superior gluteal artery is employed when the upper buttock tissue is used for the reconstruction.
  • IGAP Flap (lower buttock): 
The inferior gluteal artery supplies the skin and fat of the lower buttock and nourishes the inferior gluteal artery perforator or IGAP flap. The IGAP flap is harvested from the lower buttock. The scar that results from harvest of this flap is designed to lie within the natural lower buttock crease.

Fact Sheet

General anaesthesia.

6-8 hours.

Length of stay
4-5 nights following the operation.


Early (1-2 days):

Bleeding (haematoma)
Failure of flap (approx 4%)
Re-operation (approx 4%)
Wound breakdown
Necrosis of mastectomy skin flaps

Later (after one week):

Reduced or no sensation of reconstructed breast

Asymmetry of buttock


Immediately after the operation

  • You will feel bruised and sore and there will be some swelling
  • Pain is usually moderate and controlled with standard painkillers
  • You will be out of bed the next day and over the next few days you will increase the amount of walking that you do

After return home

  • Socialising with friends 2-3 weeks
  • Return to work at 4-6 weeks
  • Driving at 4 weeks
  • Swelling and bruising 6-8 weeks
  • Wear compression garment for 4 weeks
  • Return gym and strenuous activity after 3 months
  • Final result at 4-6 months