I-GAP flap reconstruction

What is an IGAP flap?

One of the newest developments in breast reconstruction is the use of the IGAP flap. This is a flap taken from the inferior buttock, in cases where there is excess skin and fat available in that area. The IGAP flap is a free flap and therefore microsurgery is needed. IGAP stands for: Inferior Gluteal Artery Perforator.

Who qualifies for an IGAP flap?

The IGAP flap is an option for women who don\’t have ample abdominal tissue but still wish to have an Own Tissue breast reconstruction. The choice between an IGAP flap and an SGAP flap will depend on both the patient’s preference and which area offers the better tissue.

What risks are associated with the IGAP procedure?

The IGAP flap is more difficult to raise than the DIEP flap, as the blood vessels are smaller and shorter. As well as the general risk of microsurgical surgery, some patients experience pain in buttock crease region, which will be temporary.

Will there be any asymmetry?

As the tissue is borrowed from another area, a certain degree of asymmetry will be noticeable. But a good deal of study shows that most patients are not unduly bothered by this. The scar for this operation ends up in the buttock crease and remains there without migration inferior (i.e. where the scar ends up being lower than the original buttock line).

How do you decide between an IGAP and an SGAP Flap procedure?

There are a several things to take into consideration. Where would you prefer the scar? How much tissue is available in each area? Some reports indicate that the IGAP flap leads to more problems at the donor site than the SGAP flap does, although more research into this claim is required.

I-GAP Flap – overview

Operation time:	Normally between 5 and 8 hours
Hospital Stay:	Between 4 to 5 nights following the operation
Type of Anaesthesia:	General anaesthetic
Recovery Time:	4-6 weeks
Risks of Surgery include:	Bruising, swelling and discomfort. In rare cases, patients experience bleeding (haematoma), infection, failure of the flap (approx 4%), partial failure of flap, the need to re-operate (approx 8%), wound breakdown or necrosis of the mastectomy skin flaps. Problems occurring a week after the operation can include reduced sensation of reconstructed breast. Other (rare) problems can include scarring, an unsightly, lumpy breast; asymmetry of the buttock; seroma.
Further Treatment:	Visit to the Hospital Dressing Clinic (a week after discharge)
Nipple reconstruction:	Around 3 months later
Nipple Tattooing:	1 month after reconstruction (by your surgical team)