Reconstructive surgery using your buttocks

Superior Gluteal Artery Perforator (SGAP) Flap

The SGAP flap procedure uses your own tissue (autologous) from the upper buttock area. In an SGAP flap procedure the skin, fat and blood vessel (perforator) is completely freed from its original location in the upper buttock, transferred and attached to blood vessels in the chest area using microsurgery. This procedure results in a tightening of the upper buttock with a scar across the top of your buttock (similar to a buttock lift). The scar may not be hidden in all types of underwear/swimwear.

This procedure may involve removing a small piece of the 3rd or 4th rib or cartilage to enable access to the blood vessels on top of the lungs. Sometimes the surgeon can find these vessels in between the ribs. Alternatively, the flap can be connected to blood vessels in the axilla (armpit). This depends on your unit/surgeons preference. The surgeon will use a microscope to reconnect the blood supply.

The SGAP procedure is technically more difficult than an MS TRAM / DIEP flap from the abdomen, because the blood vessels in the upper buttock are shorter. It may be a suitable option for women who do not have enough tissue on their abdomen or inner thigh. Tissue from the buttock can feel firmer than that from the abdomen or thigh.

Inferior Gluteal Artery Perforator (IGAP) Flap

The IGAP flap procedure uses your own tissue (autologous) from the lower buttock area. In an IGAP flap procedure the skin, fat and blood vessel (perforator) is completely freed from its original location in the lower buttock, transferred and attached to blood vessels in the chest area using microsurgery. This procedure results in a lower buttock scar usually in the natural bottom crease. The scar may not be hidden in all types of underwear/swimwear and may result in a flattened buttock because of pulling.

This procedure may involve removing a small piece of the 3rd or 4th rib or cartilage to enable access to the blood vessels on top of the lungs. Sometimes the surgeon can find these vessels in between the ribs. Alternatively, the flap can be connected to blood vessels in the axilla (armpit). This depends on your unit/surgeons preference. The surgeon will use a microscope to reconnect the blood supply.

The IGAP procedure is technically more difficult than a MS TRAM or DIEP flap from the abdomen, because the blood vessels in the buttock are shorter. It may be a suitable option for women who do not have enough tissue on their abdomen or inner thigh.

The IGAP flap is less favourable than an SGAP flap because the fat and skin is removed from over the weight-bearing bone in your pelvis. This is where you bear your weight when you are sitting down. There is also a risk of causing numbness down the back of the leg, or damage to the sciatic nerve (which runs down the back of the leg). Tissue from the buttock also can feel firmer than that from the abdomen or thigh.

Come to a Show & Tell event

Find out more about different types of procedure and the experiences of patients by coming along to one of our events.