Breast reconstruction using S-GAP and l-GAP flaps

Since 2005, we have been introducing S-GAP and I-GAP flaps for autologous breast reconstructions, mainly by our group in Japan. We have utilized the upper buttocks for moderate-size breasts in nulliparous patients. Bilateral lower buttock tissue is especially indicated for patients who have larger and high-projection breasts. Although the use of GAP flaps for breast reconstruction requires technically demanding dissections, these procedures provide thick, dense, and abundant gluteal fat. To preserve gluteal function, as well as aesthetic anatomic landmarks of the buttocks, it is very important to avoid harvesting excess gluteal soft tissue.