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. Ned Snyder, you will play a significant role in deciding 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 Snyder Plastic Surgery at The Breast and Body Center of Austin. Schedule an appointment at one of our Austin or Round Rock TX locations soon.
"I received excellent care and surgery here . Very pleased with the procedure and lab report . Dr. Jenn removed a Stage 2 Melanoma skin cancer from my leg with expertise and care . This is an excellent Dermatology and Plastic Surgery group . Thank you so much for being part of my wellness team !Sharon Spieckerman"- S.S. / Yelp / Apr 01, 2022
"A knowledgeable doctor. Felt safe and comfortable with him from the consult all the way post-op. The clinic staff are very pleasant and easy to get ahold of. Would highly recommend."- M.D. / Google / Feb 26, 2022
"Dr Snyder and his team are the best, after a double mastectomy with diep flap reconstruction. Everyone was so caring, patient, and helpful! Even when I needed help on the weekend. Thank you Dr Snyder, Jennifer, and team!"- C.G. / Facebook / Apr 30, 2022
"I had an amazing experience with beautiful results - I couldn’t be happier with my breast augmentation results. Everyone that I met from my first consultation to my post follow up after surgery were extremely helpful and informative. Dr. Snyder himself is an amazing surgeon. My results are perfect and better than I ever could have imagined. I highly recommend him if you are thinking about this procedure. His PA, Jen was extremely helpful and informative as well. The facilities from Dr. Snyder’s office to the surgical site used were clean, beautiful and comfortable. I felt well taken care the entire time and am thrilled with my results."- Anonymous / Vitals / Mar 08, 2018
"After back to back pregnancies, my body had been put through the ringer in a short period of time. I had an umbilical hernia and diastasis recti. Dr. Snyder restored my body and sanity after a mini tummy tuck and a much needed breast lift. I never imagined the results I got. They were better than I expected and my husband was very impressed as well. Dr. Snyder is a true artist! I have told all my Mommy friends to get their "Body by Snyder." Thank you Dr. Snyder for making me feel and look like myself again!"- A.D. / Google / Jun 11, 2020
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 general anesthesia. After your breast surgeon preforms a mastectomy, Dr. Ned 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.
The tissue will be transferred 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.
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.