Gluteal artery perforator free flaps for breast reconstruction

Abstract

Free flap autologous breast reconstruction is becoming more and more common for post-mastectomy reconstruction. Abdominally-based tissue flaps are the first choice for many reconstructive breast microsurgeons, but not all patients are candidates, whether due to their leaner habitus or a history of prior abdominal surgery. The gluteal donor site in many patients can provide adequate soft tissue for autologous breast reconstruction, even in lean patients, with a scar that remains well-hidden. This review presents an overview of the superior gluteal artery perforator (SGAP) flap as an invaluable tool for autologous breast reconstruction.

Keywords

Autologous breast reconstruction / reconstructive surgery / microsurgery / SGAP / gluteal artery perforator flap

References

[1] American Society of Plastic Surgeons. 2022 ASPS procedural statistics release. 2022. Available from: https://www.plasticsurgery.org/documents/News/Statistics/2022/plastic-surgery-statistics-report-2022.pdf. [Last accessed on 23 Sep 2024]

[2] Allen RJ.Deep inferior epigastric perforator flap for breast reconstruction.Ann Plast Surg1994;32:32-8

[3] Fujino T,Enomoto K.Primary breast reconstruction after a standard radical mastectomy by a free flap transfer. Case report.Plast Reconstr Surg1976;58:371-4

[4] Shaw WW.Breast reconstruction by superior gluteal microvascular free flaps without silicone implants.Plast Reconstr Surg1983;72:490-501

[5] Koshima I,Soeda S,Ohta S.The gluteal perforator-based flap for repair of sacral pressure sores.Plast Reconstr Surg1993;91:678-83

[6] Allen RJ.Superior gluteal artery perforator free flap for breast reconstruction.Plast Reconstr Surg1995;95:1207-12

[7] Blondeel PN.The sensate free superior gluteal artery perforator (S-GAP) flap: a valuable alternative in autologous breast reconstruction.Br J Plast Surg1999;52:185-93

[8] Rodriguez-Vegas M,Benito Duque P.Septocutaneous gluteal artery perforator flap in breast reconstruction: An insight into the related anatomy and preoperative imaging.J Plast Reconstr Aesthet Surg2021;74:2580-7

[9] Tuinder S,Massey MF,Van Der Huist R.Introducing the septocutaneous gluteal artery perforator flap: a simplified approach to microsurgical breast reconstruction.Plast Reconstr Surg2011;127:489-95

[10] Gagnon AR.Superior gluteal artery perforator flap.Semin Plast Surg2006;20:079-88

[11] Opsomer D,Ryx M,Van Landuyt K.Comparing the lumbar and SGAP flaps to the DIEP flap using the BREAST-Q.Plast Reconstr Surg2020;146:276e-82e

[12] Baumeister S,Peek A.The sGAP flap: rare exception or second choice in autologous breast reconstruction?.J Reconstr Microsurg2010;26:251-8

[13] Guerra AB,Bidros RS,Dupin CL.Breast reconstruction with gluteal artery perforator (GAP) flaps: a critical analysis of 142 cases.Ann Plast Surg2004;52:118-25

[14] Hunter C,Luan A,Lee GK.Superior gluteal artery perforator flap: the beauty of the buttock.Ann Plast Surg2016;76 Suppl 3:S191-5

[15] Zoccali G,Giwa L,Farhadi J.Breast reconstruction with superior gluteal artery perforator free flap: 8 years of experience.J Plast Reconstr Aesthet Surg2019;72:1623-31

[16] Kida MY,Ezoe K.The ramification of the superficial branch of the superior gluteal artery. Anatomical basis of a new gluteus maximus myocutaneous flap.Surg Radiol Anat1992;14:319-23

[17] Dallas-prunskis T.Superior cluneal nerve entrapment. In: Trescot AM, editor. Peripheral nerve entrapments. Cham: Springer International Publishing; 2016. pp. 555-64.

[18] Werdin F,Martin NC.Superior gluteal artery perforator flap in bilateral breast reconstruction.Ann Plast Surg2010;64:17-21

[19] Tuinder S,Lobbes M,Lataster A.Septocutaneous gluteal artery perforator (Sc-GAP) flap for breast reconstruction: how we do it. In: Spiegel AJ, editor. Breast reconstruction - current perspectives and state of the art techniques. InTech; 2013.