Reconstruction Using Buttock Tissue

Using tissue from the buttocks for breast reconstruction is often used with patients who do not have adequate tissue on their abdomen, cannot use their abdominal tissue due to previous surgeries, or do not want to have breast implants. The amount of tissue than can be taken from the buttock is often limited due to the firmer nature of the skin and fatty tissue. 

Superior Gluteal Artery Perforator Flap (SGAP)

The tissue "flap" taken from the buttock region includes the skin, fatty tissue and underlying blood vessels. Depending on where you have the most tissue, the flap can be taken from one of two areas: the upper portion of the buttock, which is supplied by the blood vessels known as the superior gluteal artery and vein, or the lower portion of the buttock, which is supplied by the inferior gluteal artery and vein. These flaps are taken off their blood supply and reconnected to the blood supply in the chest. Therefore, they are known as “free” flaps. The names of these flaps are the Superior Gluteal Artery Perforator Flap (SGAP) (above), and the Inferior Gluteal Artery Perforator Flap (IGAP) (below).

Inferior Gluteal Artery Perforator Flap (IGAP)

Advantages of using buttock tissue:

• Spares all or most of the buttock muscle
• Minimizes pain

Disadvantages of using buttock tissue:

• Technically more difficult than abdominal flaps
• May require multiple surgeries, especially for bilateral reconstruction
• Increased surgery time
• Area where the flap is removed will often have a slight to moderate depression or dent 
• Scarring on buttock