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SGAP Flap Reconstruction is one of the breast reconstruction techniques used by Dr. Pankaj Tiwari, Dr. Ergun Kocak and Dr. Santosh Kale, board-certified plastic surgeons of Midwest Breast and Aesthetic Surgery. They have over 20 years of combined experience providing the best breast reconstruction results for breast cancer survivors.

Insurance Coverage and Cost

SGAP Flap Reconstruction, as with other breast reconstruction procedures, is covered by healthcare insurance providers in compliance with the Women’s Health and Cancer Rights Act of 1998.

SGAP Flap vs Other Flap Reconstruction Techniques

The Superior Gluteal Artery Perforator (SGAP) Flap Reconstruction uses skin and fat along the upper buttocks and hips to reconstruct the breast. This makes it ideal for patients with little or no abdominal tissue, which is required for either DIEP flap or SIEA flap reconstruction.

The Inferior Gluteal Artery Perforator (IGAP) Flap, while similar in technique to the SGAP flap, uses tissue from the bottom of the buttock, close to the crease. Generally, the shape and size of the buttocks will determine whether the SGAP or IGAP flap surgeries will be performed. Recovery for both kinds of GAP flap procedures is similar to that of a buttock lift or buttock implant surgery.

The SGAP & IGAP Flap Reconstruction Procedure

The donor site will be determined during the consultation. Prior to the operation, your doctor will mark the appropriate areas of the buttock that will be utilized in the reconstruction. The operation is performed under general anesthesia and takes 9 – 12 hours.

Your doctor will carefully remove the appropriate flap and transfer it to the breasts for reconstruction. The tissues will be reconnected to the body’s blood supply by reconnecting blood vessels using microsurgery.

The nipples and areola can be reconstructed on request. All incisions will be closed with dissolvable sutures.


Your recovery in the hospital will be between 3 – 4 days. While in the hospital you will be taken care of in a private room. You may return home after your doctor clears you for discharge.

We recommend having a friend or family member assist you with any activity for up to 2 weeks after the surgery. We will provide you with compression garments, which must be worn continuously for 8 weeks after surgery. Do not submerge your incisions in water and avoid any exercise for up to 2 weeks. Avoid sitting down and lying on your back for 6 – 8 weeks.

You may resume light chores after 3 – 4 weeks or upon clearance from your physician.


With proper post-operative care, your scars will fade into easily-concealed thin lines after 6 – 8 weeks. Your body may absorb some of the transferred fat for up to year before the final result manifests. In general, the SGAP flap creates natural-looking and feeling breasts that can restore your balance and confidence.

Frequently Asked Questions

1. Is SGAP Flap a treatment option following double mastectomy?

Yes, if you have the appropriate tissue present in the upper buttocks. Due to the intensity of the procedure, however, it is ideal to discuss this with your surgeon during the consultation.

2. Can I get SGAP Flap immediately after mastectomy?

SGAP techniques may be used for both immediate and delayed breast reconstruction. In the case of delayed reconstruction, a filler implant (expander) will be used to temporarily increase the size of the breasts in preparation for the procedure.

For patients who have already undergone a mastectomy, your surgeon will discuss whether or not the SGAP flap can be done right away or if a filler implant (expander) is required to stretch the breast skin before the procedure.

3. When is the SGAP Flap technique used?

The SGAP is ideal for patients with little to no abdominal tissue, and are therefore not candidates for the DIEP flap procedure, and patients who prefer to use buttock region as a donor site for their reconstruction.

*The information available on this page was created to educate our patients. It is not an alternative for a formal consultation with a board-certified plastic and reconstructive surgeon. Individual results vary per patient. For more information, we strongly recommend scheduling a consultation with our doctors.