Women, who lack sufficient flesh in the abdomen for the DIEP flap reconstruction, may find that the gluteal artery perforator flap (GAP flap) is a very good alternative. This is another sophisticated perforator flap performed by our experienced, board-certified Plastic and Reconstructive Surgeon Dr. Ned Snyder IV that utilizes the skin and fat from the upper portion of the buttocks to reconstruct the breasts. Again, no muscle is utilized. Additionally, we have utilized the GAP flap in situations where the abdominal flap (such as a TRAM flap, DIEP flap, or previous tummy tuck) 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, with very little droop (ptosis).
The GAP flap breast reconstruction may take place at the time of your mastectomy or at a later date. When you consult with Dr. Snyder, you will play a significant role in deciding in what type of reconstruction you receive, when the surgery will take place, and how it is performed with the guidance of our team. We want you to feel assured that you are in excellent care with Breast and Body Center of Austin. Schedule an appointment in one of our Austin, TX locations at your earliest convenience.
After your breast reconstruction consultation, we will make contact with the breast surgeon performing your unilateral or bilateral mastectomy. Together, we will make a plan on how to best work together the day of your surgery so that you wake up with all of your surgery complete. The GAP flap reconstruction is performed as an in-patient procedure and can take up to 4 – 6 hours under a general anesthesia. After your breast surgeon removes your breasts, Dr. Snyder will carefully prepare the chest pocket and harvest the tissue from your upper buttock. Your buttocks will be left slightly flatter, but there is no great depression where the flesh is removed. If necessary, the opposite buttock can be reduce for symmetry. This should not interfere with sitting. Most women need a relatively small amount of buttock removed to make a moderate sized breast. We will keep your caregiver, friend, or loved ones updated in the waiting area on your progress if you so desire.
The tissue will be transfer to the chest and a breast mound will be formed into a normal looking and natural feeling breast. Once the surgery is finished, we will take you to recovery and then to the immediate care unit where you will stay until discharge. You may be in the hospital 3 – 4 days while we monitor your progress and give you the excellent care you deserve.
If drains are essential for excessive fluid build up, you will leave the hospital with them and have them removed at a follow-up appointment when deemed necessary. While at home, we want you to be recovering comfortably, but still walking around and staying active to avoid blood clots after surgery. A week after you leave the hospital, we will have a follow-up appointment to check on your progress and release you to do certain activities if you are able. If you have any complications such as excessive pain, fever, swelling, abnormal bleeding, or a reaction to the medications you are taking, please call our office immediately. We are here to help. Recovery time is different for each breast reconstruction patient. If you had a more complex surgery to reconstruct your breast, this could mean a longer recovery period.
Plan Your Procedure
- Recovery Time
- 4 – 6 Weeks
- Average Procedure Time
- 4 – 6 Hours
- Post-op Follow-up
- 7 Days
- Procedure Recovery Location
GAP FLAP FAQs
How Will I Control The Pain?
During surgery, we use a long acting anesthetic that is diffused directly into your tissues. Most patients have very little pain immediately after surgery. You will also be given pain medication through your IV after surgery. During your hospital stay, you will be switched to pain medication given by mouth. There are many options we can use for pain control. This will be discussed in further detail if desired. It is important to inform us if you have any drug allergies.
Is Smoking OK?
You will not be a candidate for procedure if you use tobacco in any form, including patches, pills, and gums. It is extremely important that you refrain from smoking or using any nicotine products (including patches, pills, gums, and e-cigs) for at least 6 weeks prior to surgery. Smoking can dramatically impair wound healing and complicate your post-op care.
Will I Need a Nurse at home?
You may not need a registered nurse to care for you at home, but you will need a family member or friend to be your caregiver for awhile. You will be in the hospital 4 – 6 days with around the clock care. When you are discharged to go home, you may not be able to accomplish normal, everyday tasks on your own for a few weeks. When asking a friend or a loved one to take on the responsibility of your care, this person must be able to help you bathe, dress, go to the bathroom, change bandages, go to the pharmacy, and much more.