SGAP flap
Implant based breast reconstruction
Autologous breast reconstruction
A proportion of women requesting autologous (without an implant) breast reconstruction, are slim and do not have enough fat tissue in the lower abdomen to perform a DIEP flap. Others may have had surgical procedures in the past to the abdomen, which because of the position of the position of the scars means that this is not possible. In these cases, an SGAP (Superior Gluteal Artery Perforator) flap is an option.
This is a relatively new technique in which skin and fat from the buttock is moved to the chest to create a new breast. Mr Roblin is one of a few surgeons in the United Kingdom currently performing this procedure and has the largest series of reconstructions with this technique.
In the majority of patients, the abdominal fat (TRAM) flap is preferred as it is technically less demanding and the abdominal fat softer. In the appropriately chosen patient though, the SGAP flap can produce excellent results. Recovery is quicker than a TRAM flap and at 3-4 weeks the patient can expect to have made a near full recovery.
Further information
Anaesthetic
The operation is performed under general anaesthesia. The operation takes 5-8 hours.
Length of stay
4-5 nights following the operation.
Risks/Possible complications
Early (1-2 days):
Frequent
- Bruising
- Swelling
- Discomfort
Infrequent
- Bleeding (haematoma)
- Infection
- Failure of the flap (approx 4%)
- Partial failure of flap
- Re-operation (approx 4%)
- Wound breakdown
- Necrosis of the mastectomy skin flaps
Later (after one week):
Frequent
- Reduced or no sensation of reconstructed breast
Infrequent
- Scars - abdominal, umbilicus, breast unsightly, lumpy, stretch
- Asymmetry of the buttock
- Seroma
- Fat necrosis
General anaesthetic
- Deep vein thrombosis
- Chest infection
- Allergic reaction to drugs or tape
Recovery
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
- There will be drains in the chest and the buttock, which will be removed between 2-5 days later
- A urinary catheter will be left in for 2 days until you are mobile
- 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 1-2 weeks
- Return to work at 4 weeks
- Driving at 4 weeks
- Swelling and bruising 6-8 weeks
- Wear buttock compression garment for 5 weeks
- Return gym and strenuous activity after 3 months
- Final result at 4-6 months
Permanence of results
Permanent.