[Breast reconstruction with superior gluteal artery perforator (SGAP) flap without intraoperative setup change. About...

The superior gluteal artery perforator flap (SGAP) typically requires a peroperative change of the patient's position that increase the duration time of the procedure and the hospitalization. The aim of this study is to present our serie of eight consecutive SGAP flaps without setup change, and to precise the surgical technique we used.

This is a retrospective series of eight consecutive SGAP flaps performed between September 2001 and March 2010. All these flaps were performed without peroperative setup change. We studied the number of perforators used and their origins, the type of recipient vessels, the duration time of the procedure and the hospitalization. We also analyzed the morphological and functional outcomes for the donor site.

All eight flaps were raised on a single septo-cutaneous perforator located between the gluteus maximus and gluteus medius muscles. The internal mammary vessels were chosen as recipients in all cases. The average duration time of the operation was 6 hours and 5 minutes. We report one flap loss. No functional or morphological complications were reported on the donor site. The morphological results on the reconstructed breast were satisfactory or very satisfactory in most cases.

A satisfying breast reconstruction can be achieved with the SGAP flap without changing setup. The use of the septo-cutaneous branch between the gluteus maximus and gluteus medius muscles lengthens the pedicle and reduces the surgery time by facilitating the dissection. SGAP is therefore another autologous technique for breast reconstruction with low morbidity, when a DIEP flap cannot be harvested.