GAP Breast Reconstruction & Other Free Flap Procedures

Charleston breast reconstruction patients have options for autologous reconstruction (using your own body’s tissues) even if they are not a candidate for the DIEP flap technique. Dr. O’Neill is experienced in performing free flap procedures. The techniques used for these free flap procedures are very similar to the DIEP reconstruction.  Any of the free flap procedures may be delayed until the patient is ready to proceed with the breast reconstruction or they can be done at the time of the mastectomy.

GAP Flaps

Women who are slender or have abdominal scarring from previous surgical procedures may not be candidates for the DIEP reconstruction. If this is the case, your surgeon may take skin and fat from either your upper (“superior”) or lower (“inferior”) buttock region. These are referred to as the “sGAP flap” or “iGAP flap” respectively. Both of the incisions from these surgeries are easily hidden with underwear.

gap breast reconstruction charleston sc

Image Source: Johns Hopkins, hopkinsmedicine.org

TUG Flaps

The TUG flap (transverse upper gracilis) uses the inner portion of the upper thigh, just under the groin crease. This may be an option for women who are not candidates for a DIEP or choose not to have an abdominal scar. The scar is generally well hidden near the groin crease and patients also receive the added benefit of an inner thigh lift. Women who have a TUG flap reconstruction generally have small to medium sized breasts.

SIEA Flaps

The SIEA (Superficial Inferior Epigastric Artery) is very similar to the DIEP flap. The main difference between the two procedures is the artery used to supply the blood flow to the new breast. The SIEA blood vessels are found in the fatty tissue below the skin of the abdomen, while the DIEP vessels are found deeper and within the abdominal muscle (which can make the procedure more technically difficult). Both procedures spare the abdominal muscle and use only the skin and fatty tissue.

The SIEA flap is only performed in only 10-20% of patients who want to use their abdominal tissue to reconstruct their breast because the SIEA vessels are most often too small to provide sufficient blood flow to the new breast. There are pre-operative tests that can determine whether the SIEA vessels can be used for reconstruction.

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Schedule Your Consultation in Charleston

Are you or a loved one interested in finding out more about reconstructive breast surgery? Schedule an appointment to talk with Dr. O’Neill and our expert staff in our plastic surgery clinic in Charleston, SC, conveniently and privately located on beautiful Daniel Island. Call us at 843-881-2130 or contact us online now.