The gluteal artery perforator flap (GAP) flap is another sophisticated perforator flap that utilizes the skin and fat from the upper portion of the buttock.  Again, no muscle is utilized.  For women who lack sufficient flesh for the DIEP flap reconstruction this is a very good alternative.  Additionally, we have utilized the GAP flap in situations where the abdominal flap (either TRAM flap or DIEP flap) has already been utilized, or scars on the abdomen preclude its use for breast reconstruction.

The breast reconstructed with the GAP flap is soft, natural, and with very little droop or ptosis.  The buttock is left slightly flatter, but there is no great depression where the flesh has been removed.  This can be improved if necessary with liposuction of the opposite buttock.  Most women need a relatively small amount of buttock removed to make a moderate sized breast.  Because the flesh utilized is from the upper buttock, sitting is not interfered with.  Recovery times are slightly shorter than with the DIEP flap.