With an SGAP flap, an incision is made along the top of your buttocks. With an IGAP flap, the incision is made in the crease of your buttocks. In both types of GAP flaps, an oval section of skin, fat, and blood vessels is taken from your buttocks and moved up to your chest and formed into a breast shape. No muscle is moved. The tiny blood vessels that feed the tissue of your new breast are matched to blood vessels in your chest and carefully reattached under a microscope.
Either GAP flap procedure lasts about 9 to 12 hours.
After GAP flap reconstruction surgery: You'll be moved to the recovery room after surgery, where hospital staff members will monitor your heart rate, body temperature, and blood pressure. If you're in pain or feel nauseous from the anesthesia, tell someone so you can be given medication.
You'll then be admitted to a hospital room. For both types of GAP flaps, you usually stay in the hospital for about 4 days.
It can take about 6 to 8 weeks to recover from GAP flap reconstruction surgery. Your doctor may recommend that you wear a compression girdle for up to 8 weeks after surgery. Because you've had surgery at two sites on your body (your chest and your buttocks), you might feel worse than someone who had only a mastectomy, and it will probably take you longer to recover. You'll likely have to take care of two incisions: on your breast and your buttocks, and you'll probably have drains in your reconstructed breast and in your buttock donor site. You may need to have help taking care of the incision on your buttocks and it may be uncomfortable for you to sit down for a week or more after surgery. If you had axillary node dissection at the same time, you’ll have a third incision and drain to take care of under your arm.
It's important to take the time you need to heal. Follow your doctor's advice on when to start walking, stretching exercises, and your normal activities. You usually have to avoid strenuous sports, sexual activity, and lifting anything heavy, for about 6 weeks after GAP flap reconstruction.
It sometimes takes as long as a year or more for your tissue to completely heal and for your scars to fade.