Gluteal perforator flap (SGAP)
The superior gluteal artery perforator (SGAP) flap is a technique that uses tissue from the upper buttock for breast reconstruction. It involves isolation of the perforating blood vessels through the gluteal muscle and spares the muscle entirely. The flap is then removed from the buttock area and transferred up to the chest. A microscope is then used to reconnect the vessels and blood flow is once again established. The flap is then contoured to create a new breast. It is an excellent option for women that do not have enough abdominal tissue for reconstruction.
The scar is located at the upper buttock and can be easily hidden with underwear or bathing suits. The surgery requires more time than a DIEP flap because of the multiple position changes in the operating room. Dissection of the vessels can also be more complicated. Because of these reasons, if there is enough abdominal tissue, it is the preferred donor site for reconstruction.