SGAP/LGAP St. Louis - Breast Reconstruction Technique Missouri
In this procedure, a woman’s own buttock tissue is used to reconstruct the breast. No implants are used as part of the reconstruction. Depending on the woman’s buttock shape, the upper buttocks (SGAP) or the lower buttocks (LGAP) may be used.
Candidates for this procedure include patients who are having or have had a mastectomy or are unhappy with a previous expander/implant reconstruction. Patients with previous radiation are also excellent candidates for this procedure. Women who do not desire abdominal flap reconstruction or are unable to have reconstruction with their own abdominal tissue as a result of prior abdominal surgery or inadequate volume of tissue are also candidates.
Poor candidates for this surgery are women who have little fat on their buttocks and, therefore, may not be able to attain the breast size they desire.
Preparing for Surgery
Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin, ibuprofen or any other type of blood thinner. If you are taking chemotherapy, this will need to be finished prior to surgery.
During the procedure, the breast surgeon performs the mastectomy first. If a mastectomy has already been done, then Dr. Cabbabe begins with the patient on their abdomen. Either the upper or lower buttock is used, depending on a patient’s anatomy. Tissue including skin and fat is removed along with an artery and vein attached. The site where the tissue was removed is closed with sutures and a drain is placed. The patient is then flipped onto their back. Blood vessels between the ribs are identified to provide inflow of blood into and out of the skin and fat from the buttock. Under a microscope, the artery and vein (s) are reconnected with fine sutures to re-establish blood flow to the flap. The breast is then shaped and molded on the chest to recreate the breast.
Due to the fact that the operation begins with the patient on their stomach or side and then requires the patient to be turned to lie on their back, only one breast can be reconstructed at a time. This is due to time restraints; this surgery can take up to 10 to 12 hours per breast.
A breast lift or reduction may be needed on the other breast in order to improve symmetry if a unilateral mastectomy is being done.. A new nipple can be made and areolar tattooing can be done if desired in the case of mastectomy.
You will be admitted to the hospital for two to four nights. Pain medication and antibiotics will be prescribed. Dr. Cabbabe and the nursing staff will continually monitor the tissue flap. You will take aspirin daily for up to 6 weeks and be asked to avoid caffeinated beverages for a couple of weeks. There may be some numbness on the breast and buttocks which improve with time. Most patients are able to shower within 24 hours. Drains will be placed inside the breast and in the buttock. Recovery is approximately 3 to 6 weeks.
Types of Reconstruction:
- Fat Grafting
- Oncoplastic Breast Reconstruction (one – stage)
- Tissue Expander – Implant (two – stage)
- Tissue Expander – Implant with Acellular Dermis (two –stage)
- Implant with Acellular Dermis (one-stage)
- Latissimus Flap (one – stage)
- Latissimus Flap with Expander – Implant (two – stage)
- Latissimus Flap with Implant (one-stage)
- Conventional TRAM (one – stage)
- Free Muscle – Sparing TRAM (one –stage)
- DIEP Flap (one – stage)
- SIEA Flap (one – stage)
- SGAP/LGAP (one – stage)
- Fat Transfer Breast Augmentation
- Breast Implant Reconstruction (One-stage)
- Breast Implant Revision Surgery
- Breast Tissue Expander – Implant Reconstruction (2-stage)
- Latissimus Flap Breast Reconstruction
- Latissimus Flap Breast Reconstruction with Implant (1-stage)
- Latissimus Flap with Implant Breast Reconstruction (2-stage)
- Transverse Upper Gracilis (TUG) Flap Breast Reconstruction