Answers to Common GAP Flap Questions

As a breast reconstruction surgeon located in the New York Metro area, I get a lot of questions from women from all walks of life who want to learn more about their reconstructive options following mastectomy. Many women come to me from all parts of New York and across the country to learn more about GAP flap breast reconstruction. On this page I have put together a few of the more common questions I get about this technique. For more detailed questions or to find out if you are a candidate for this procedure, request a phone consultation with me or call the practice at 516-482-1100 to schedule an appointment.

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FAQ's about GAP Flap

What is the difference between the sGAP and the iGAP flap?

The sGAP is taken from the upper part of the buttock and extending into the love handle area. The iGAP is taken from the lower part of the buttock. The sGAP does not really change the contour of the backside. Tissue taken is above the sitting area of the buttock. The scar can be hidden within the bathing suit line. If a particular type of bathing suit is preferred, the outline of the swimwear is marked on the patient so that the design of the flap allows the scar to be hidden. The iGAP flap is taken in the crease of the buttock. While the scar can be hidden, the natural curve of the buttock is flattened. Additionally, this scar lies over the sciatic nerve. I am not enthusiastic about the iGAP flap for the above reasons.

Does the sGAP flap give as good a breast reconstruction has the DIEP flap?

With careful selection of the appropriate patient, the sGAP flap can make for a very good breast reconstruction. Typically, the GAP flap is offered to patients who are not good candidates for DIEP flap breast reconstruction. To be a good candidate for the GAP flap, there must be a small amount to skin that is required (wide flaps in general are not possible, the buttock should be soft so that the tissue will feel like breast, and the patient should not be overly obese.

Many surgeons who offer the DIEP flap do not offer the GAP flap. Why is that?

The GAP flap poses additional technical challenges for the surgeon. Because the tissue taken is from the backside, the patient must be positioned so that access to the chest and the backside is possible. The perforating blood vessels to this flap are larger than the DIEP flap but overall the pedicle is shorter. This can pose technical problems with both the pedicle dissection, and the positioning of the flap on the chest. A microsurgeon comfortable with these extra requirements will perform the GAP flap for breast reconstruction with a high degree of success.