With an SGAP flap, an incision is made along the top of your buttocks and an oval section of skin, fat, and blood vessels is taken from your upper 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. Two new breasts would be created in this way (GAP flaps tend to make the most sense for women who are having both breasts reconstructed).
The SGAP flap procedure lasts about 9 to 12 hours. Many plastic surgeons prefer to do each breast separately, which means two different operations spaced a few months apart. You may wish to search for an experienced team that could do the surgery in one operation, with two surgeons working on different sides of the body at the same time.
After SGAP 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 nauseated from the anesthesia, tell someone so you can be given medication.
You'll then be admitted to a hospital room. You usually stay in the hospital for about 4 days.
It can take about 6 to 8 weeks to recover from SGAP flap reconstruction surgery. Your doctor may recommend that you wear a compression girdle for up to 8 weeks after surgery. If you’re choosing immediate reconstruction, it’s important to keep in mind that since you’ve had surgery at multiple sites on your body (your chest and your hips/upper buttocks), depending on whether you had reconstruction on just one side or both sides at once, you might feel worse than someone who had only a mastectomy. It will likely take you longer to recover. You'll also have to take care of multiple incisions: on your breast(s) and your upper buttocks, and you'll probably have drains in your reconstructed breast(s) and in your buttock donor site(s). You may need to have help taking care of the incision on your upper 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 may have incisions and drains to take care of under your arms.
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 SGAP flap reconstruction.
It sometimes takes as long as a year or more for your tissue to completely heal and for your scars to fade.