Like all surgery, IGAP flap surgery has some risks. Many of the risks are the same as the risks for mastectomy. However, there are some risks that are unique to IGAP flap reconstruction.
Tissue breakdown: In rare instances, the tissue moved from your lower buttocks to your breast area won't get enough circulation and some of the tissue might die. Doctors call this tissue breakdown “necrosis.” Some symptoms of tissue necrosis include the skin turning dark blue or black, a cold or cool-to-the-touch feeling in the tissue, and even the eventual development of open wounds. You also may run a fever or feel sick if these symptoms are not addressed immediately. If a small area of necrosis is found, your surgeon can trim away the dead tissue. This is done in the operating room under general anesthesia or occasionally in a minor procedure setting. If most or all of the flap tissue develops necrosis, your doctor may call this a “complete flap failure,” which means the entire flap would need to be removed and replaced. Sometimes the flap can be replaced within a short timeframe, but in most cases the surgical team will remove all the dead tissue and allow the area to heal before identifying a new donor site to create a new flap.
Lumps in the reconstructed breast(s): If the blood supply to some of the fat used to rebuild your breast is cut off, the fat may be replaced by firm scar tissue that will feel like a lump. This is called fat necrosis. These fat necrosis lumps may or may not go away on their own. If they don't, it's best to have your surgeon remove them. After having mastectomy and reconstruction, it can be a little scary to find another lump in your rebuilt breast. Having it removed can give you greater peace of mind, as well as ease any discomfort you might have.
Sciatica: Sciatica is intense, sharp pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. With IGAP flap surgery, there is a small risk that the sciatic nerve could be nicked or damaged as the surgeon accesses the donor tissue and blood vessels, which would lead to sciatica.
“Lopsided” buttock if you only had one breast reconstructed: If only one buttock was used as a donor site, your buttocks may look uneven after this surgery. This can be corrected with liposuction to the other side.