Using Living Tissue for Natural-Looking Results in Austin, TX
A gluteal artery perforator or GAP flap at Austin Plastic & Reconstructive Surgery is an advanced breast reconstruction technique, similar to the DIEP flap, in which your surgeon uses your own excess tissue—not an implant—to create your new breast without removing any underlying muscle or damaging your motor nerves. The result is a breast that looks and feels natural. Since the mound is made of healthy living tissue, it will not require any future implant replacement.
The GAP Flap Breast Reconstruction Technique
For the GAP flap technique, your surgeon removes a flap of skin and fat from either your upper buttock (in which case it is called a superior gluteal artery perforator or SGAP flap) or your lower buttock (an inferior gluteal artery perforator or IGAP flap). Although there may be some flattening of the buttock where the flap is removed, the change is typically slight. If needed, liposuction can be used on the intact buttock to contour and improve symmetry. All of these options will be discussed with you in detail during your initial consultation.
A GAP flap breast reconstruction is an appropriate option for patients without enough abdominal skin and fat for a DIEP flap or who have already had liposuction or a tummy tuck. If you are only reconstructing one breast and do not have enough tissue in a single buttock, a stacked GAP or hybrid GAP approach could allow you to qualify for GAP surgery. And if you desire more volume than what you can achieve with the GAP flap procedure alone, incorporating breast implants may be the perfect solution.
Once the flap has been removed from your buttock, it is then carefully shaped to replace the removed breast tissue, and transferred to your chest. The blood vessels in the tissue are connected to vital corresponding vessels in the chest wall or under the arm. Because the vessels are remarkably small and must be severed, then connected anew under a microscope, it is important that patients choose a surgeon who has advanced skills, significant experience, and training in microsurgery.
The GAP flap technique requires more initial operating time than an implant reconstruction, but the reconstruction is complete in one surgery. It is unlikely that you will need follow-up procedures in the future, and the same can't be said for implant reconstruction patients. Implants are not lifetime medical devices and may eventually need to be repaired or replaced. Additionally, the outcome of GAP flap surgery tends to look and feel more natural than implant reconstruction results. For these reasons, GAP flap is an ideal breast reconstruction technique for many of our patients.
Benefits of GAP Reconstruction
GAP flap breast reconstruction offers several benefits for individuals seeking breast reconstruction after mastectomy. Some of the key advantages include:
- Natural-Looking Results: GAP flap reconstruction utilizes your body's own tissue, typically from the hips/buttock area, to reconstruct the breast. This allows for the creation of a breast mound that closely resembles the shape, feel, and contour of a natural breast. The result is a more natural and aesthetically pleasing outcome.
- Long-Lasting Results: The transferred tissue in GAP flap reconstruction establishes a new blood supply in the chest, ensuring long-term viability. This means that the reconstructed breast can maintain its shape, volume, and appearance over time.
- Minimizes Implant-Related Concerns: As GAP flap reconstruction does not involve the use of implants, individuals who may have concerns about implant-related complications or the need for future implant revisions can find this procedure appealing. It provides a viable alternative for breast reconstruction without the reliance on synthetic implants.
- Simultaneous Body Contouring: One of the unique advantages of GAP flap reconstruction is that it allows for simultaneous body contouring. The tissue harvested from the buttock area for breast reconstruction can result in a more lifted and perky buttock appearance, potentially providing a secondary cosmetic benefit.
- Emotional and Psychological Well-being: Breast reconstruction, including GAP flap reconstruction, can have a positive impact on a person's self-image, confidence, and overall emotional well-being. It allows individuals to regain a sense of wholeness and femininity after mastectomy, contributing to improved quality of life.
It's important to consult with a board-certified plastic surgeon who specializes in breast reconstruction to determine if GAP flap reconstruction is the right choice for you. They can assess your individual needs, discuss the potential benefits in detail, and provide personalized recommendations based on your unique circumstances.
GAP Flap Reconstruction Timing
Flap reconstruction can be performed in different ways depending on your individual situation. It can be done simultaneously with mastectomy (immediate reconstruction), after mastectomy and other treatments (delayed reconstruction), or through a staged approach where some reconstructive surgery is done at the same time as mastectomy and additional procedures are performed later (delayed-immediate reconstruction). The choice of timing and the approach will be determined by your specific needs and the recommendations of your healthcare team.
Austin Plastic & Reconstructive Surgery
- Known for natural-looking aesthetic results in breast reconstruction and cosmetic surgery.
- Elected by peers for inclusion in Texas Monthly's Texas Super Doctors®: Rising Stars listing.
- Reconstructed over 6,000 patients, including more than 2,500 DIEP flap reconstructions.
- 4.9-star average rating over hundreds of reviews for reconstructive and cosmetic surgery.
A Personal Touch is Important
Being as informed as possible about GAP flap surgery is an important factor in a successful procedure, but women choosing Austin Plastic & Reconstructive Surgery certainly do not have to be experts in the details of this or any other procedure prior to their initial visit. Our surgeons emphasize ongoing patient education, from presenting basic information online for the general public to answering unique questions during the initial consultation and making themselves available for reassurance and guidance throughout every step of the reconstructive process.
GAP Flap Recovery and Results
Your recovery will require three to four days of rest in the hospital, where the GAP flap can be monitored. Once home, most patients find that they are sore and low on energy in the weeks following their surgery but that they can return to gentle walking and driving two weeks after the procedure. Strenuous activity and heavy lifting should be avoided for at least six weeks.
It's important to keep in mind that while you’re recovering from surgery, at least two and up to four areas of your body will be healing at the same time — these areas include your reconstructed breast(s) and one or both buttocks, depending on whether one or both breasts are being reconstructed at the same time and the specific GAP flap technique that is used during surgery.
The results of flap reconstruction surgery using the GAP technique are known for looking and feeling natural. That is because the buttocks tissue used to rebuild your breast mound after breast cancer surgery is similar to breast tissue in many ways. Additionally, these results can easily last for a lifetime, as there are no breast implants to repair, replace, or maintain.
Be aware that reconstructed breasts, like other parts of your body, can be affected by weight fluctuations. If you experience weight gain or loss after GAP surgery, the size of your reconstructed breast(s) may also change accordingly. Meanwhile, minor weight fluctuations are unlikely to result in noticeable changes to your breasts.
Download Our Breast Reconstruction Post-Operative Care Guides
We've compiled detailed post-operative care instructions to best equip our breast reconstruction patients throughout their recovery process. To ensure the best and safest recovery, your plan encompasses appropriate prescriptions and clear directions towards maintaining your comfort to get you back to normal life and activity as soon as possible. Individual patients respond uniquely, and the type of procedure may differ, but these basic guidelines will help you along your journey.
GAP Flap Risks and Side Effects
GAP flap breast reconstruction is a remarkable procedure that can offer natural and long-lasting results. Like any surgical intervention, it does come with potential risks, but these can be effectively minimized by visiting a board-certified plastic surgeon and following good pre- and post-care practices. By taking these proactive steps, you can help ensure the best outcome.
One potential risk of GAP flap breast reconstruction is the possibility of flap complications, such as partial or complete flap loss. However, by selecting a skilled and experienced board-certified plastic surgeon who specializes in these procedures, you can significantly reduce these risks. A qualified surgeon will meticulously assess your individual situation, ensuring that you are an appropriate candidate for the procedure and that your overall health and lifestyle support successful outcomes.
Additionally, practicing good pre- and post-care is vital for minimizing risks and optimizing results. This includes following your surgeon's preoperative instructions, such as quitting smoking and avoiding certain medications, to promote healthy healing. After the procedure, diligently adhering to postoperative guidelines, such as proper wound care and activity restrictions, can further enhance your recovery and minimize the risk of complications.
Again, by choosing a board-certified plastic surgeon who specializes in GAP flap breast reconstruction and embracing a proactive approach to pre- and post-care, you can greatly minimize the risks associated with this breast reconstruction procedure.
Women who want nipple reconstruction to touch up the look of the breast may have this done during their breast reconstruction surgery, or they can wait to have it done during a second surgery three months later, for touching up the look of the breast. Austin Plastic & Reconstructive Surgery makes the option available for women who would like a three-dimensional tattoo colored and textured to resemble a natural areola and nipple.
No matter the details, the ultimate goal is a breast that looks, feels, and moves like it should.