IGAP Flap Procedure
Sometimes the decisions associated with breast reconstruction can seem daunting, if not overwhelming. Not only do you need to decide on the shape and size of your reconstructed breast tissue, but you also need to choose the origin of that implant—saline, silicone, donor tissue and so on. Sometimes it’s helpful to keep in mind that the reason so many options exist is to honor your individual journey. These options exist to help women achieve optimal results no matter their starting point. One of these particular options is a procedure known as an Inferior Gluteal Artery Perforator (IGAP) Flap Procedure.
What Happens During an IGAP Flap Procedure?
As with many breast reconstruction procedures that use donor material, IGAP flaps are differentiated by the location of the donor tissue. In this case, the donor tissue comes from the lower buttock area. In this regard, IGAP flap procedures are very similar to SGAP flap procedures, which take donor material from the top of the buttock area. In the end, the decision to pursue an IGAP or an SGAP flap procedure may stem from whether the upper or lower buttocks have more viable donor tissue. During the IGAP flap procedure, not only is donor muscle taken from the lower buttocks, but so too is a blood vessel—an artery and a vein.
The muscle is inserted into a pocket created by a tissue extender device (which is at that point removed). The blood vessel is attached to the chest using microsurgical techniques, allowing the new tissue to continue receiving the blood it needs to remain healthy. The size of the muscle needed from the donation area will depend largely upon the desired shape and size of the breast once reconstructed. Additionally, IGAP flap procedures are most often utilized when standard abdominal DIEP or TRAM flap procedures are, for whatever reason, not feasible and not recommended. IGAP flap procedures offer a viable and often desirable alternative.
Am I a Good Candidate for an IGAP Flap Procedure?
Not all procedures fit all patients, so if you think you’re a candidate for an IGAP Flap procedure, you should check to see if you meet any of these criteria:
- You are in generally good physical condition and can withstand the stresses of major surgery
- You have undergone or are planning to undergo a mastectomy
- Your breasts have been damaged or are missing due to lumpectomy, radiation, injury, or birth defect
- Your breast abnormality or trauma causes you to feel less feminine or simply makes you unhappy or unsatisfied
- You have ample tissue for donation in your upper buttock area
- You desire the most natural looking and natural feeling breasts possible
The plastic surgeons at East Coast Advanced Plastic Surgery know how sensitive this topic can be, and have a great deal of experience assisting patients through this transition. We also know that this is a partnership, so during our consultation we’ll discuss what you’re desired goals might be and the best way to reach those goals. In order to do that, you should be prepared to discuss your complete medical history, including recent procedures and treatments—as well as procedures and treatments that may be forthcoming and are currently scheduled. Your level of openness with the plastic surgeons at ECAPS will directly impact the longevity and probability of you successfully reaching your desired look.
Special Considerations for an IGAP Flap Procedures
Your personal history and personal journey will factor greatly into whether an IGAP Flap is the best option for you, but there are also considerations which the plastic surgeons at East Coast Advanced Plastic Surgery take into account more generally, including:
Age: While breast reconstruction for mastectomy patients may take place at any age, it’s also optimal to wait until the breast tissue has fully developed, sometimes into the early 20’s.
Cancer Treatment: Ongoing cancer treatments can affect the timing of certain procedures, and can dictate which procedures are performed at which time. It is important to discuss with your plastic surgeon how your cancer treatment will affect your reconstruction. At times, multiple procedures may be necessary for optimal reconstruction outcomes.
Pregnancy: It is important to inform your ECAPS surgeon if you are considering having children in the future. Pregnancy can cause bodily changes, which can affect the long-term results of your surgery. Your ECAPS surgeon may have special instructions on how to care for your results.
Surgery and Recovery
As with many breast reconstruction procedures, IGAP Flap surgeries will generally require a hospital stay and general anesthesia. During the procedure, the surgeon will make an incision along the lower side of the buttock, in an area where the scar will ideally be hidden by the natural folds of your body. The surgeon will remove the necessary tissue and blood vessel and place it inside the breast. This will cause further scarring, but these scars will generally be hidden by normal clothing. Your ECAPS surgeon may place surgical drainage devices in your incisions to help ease swelling and protect your results.
Your hospital stay will generally extend between three and four days. You can also expect an extended recovery time of between four and six weeks, though general soreness should subside after a week or so—this is also when, if drainage has slowed, your surgical drains will be removed. It’s important to follow your recovery instructions thoroughly, as the personalized plan you receive from your ECAPS plastic surgeons will be designed to safeguard your results for some time to come. Once your recovery is complete, your breasts should look and feel natural, and you should have no trouble achieving your desired look.