Advanced Microsurgery for the Athletic Physique

The standard approach to autologous breast reconstruction usually centers on the abdomen. The DIEP flap (Deep Inferior Epigastric Perforator) is the industry gold standard, using excess abdominal tissue to rebuild the breast. But for many women in Chandler, a community known for its active, outdoor lifestyle, that option simply doesn't exist.

Whether you are a cyclist in the Price Corridor or a yoga instructor in Ocotillo, you may be naturally lean. If you lack the necessary pinchable belly fat or if you have previously undergone a tummy tuck, you might have been told that breast implants are your only choice.

At Southwest Breast & Aesthetics, we reject that limitation. We specialize in the S-GAP flap (Superior Gluteal Artery Perforator), a sophisticated surgical procedure that uses tissue from the upper buttock to create a natural, living breast. We are among the few plastic surgeons in the Phoenix area with the extensive experience required to perform this complex flap reconstruction, ensuring that your anatomy does not dictate your outcome.

What Is the S-GAP Flap?

The S-GAP flap is a muscle-sparing technique that harvests skin and fat from the upper gluteal region to build a breast mound.

The Name: S-GAP stands for Superior Gluteal Artery Perforator.
The Technique: Unlike older gluteal flaps that sacrificed the gluteus maximus muscle (leading to long-term weakness), the S-GAP is a true artery perforator flap. We carefully dissect the blood vessels that travel through the muscle without cutting the muscle fibers themselves.
The Result: We transfer this harvested tissue to the chest and reconnect the tiny vessels to the internal mammary system under high-magnification microscopes. This restores blood flow instantly, keeping the tissue alive permanently.

This procedure allows us to use your own body to create a natural look and feel, avoiding the need for synthetic implants or the cycle of future exchange surgeries.

Am I a Candidate for S-GAP?

The S-GAP is typically a Plan B or Plan C for patients who cannot undergo a DIEP flap. You might be an ideal candidate if:

You lack abdominal tissue: You are too thin for a DIEP flap or have a flat, athletic abdomen.
You have shelf tissue: You have excess tissue in the upper hip/buttock area.
You want to avoid implants: You desire a permanent, natural tissue reconstruction.

During your private consultation at our Chandler clinic, our reconstructive surgeon will evaluate your medical history and body habitus. We may also explore other innovative procedures if the S-GAP isn’t the right fit, such as the PAP flap (thigh), LAP flap (Lumbar Artery Perforator from the love handles), or the TUG flap (Transverse Upper Gracilis).

The Microsurgical Advantage: Why It Matters

Flap surgery is not standard plastic surgery. It is microsurgery. It requires connecting blood vessels thinner than a strand of hair to ensure the blood supply is robust enough to keep the new breast alive.

At Southwest Breast, we operate with the highest volume and highest quality protocols. Our skilled hands are trained to handle the most challenging anatomical variances.

Vessel Matching: Gluteal vessels are often shorter than abdominal ones. We have the expertise to perform vein grafts if necessary to ensure a tension-free connection.
Sensory Potential: Because the gluteal tissue is rich in nerves, some patients experience a return of sensation in the reconstructed breast over time.
Complex Cases: We regularly perform breast revision surgeries, including breast implant removal and conversion to flaps for patients suffering from capsular contracture or implant illness.

The Procedure: What to Expect

S-GAP flap surgery is a major operation, typically lasting 6–10 hours. It is performed under general anesthesia at an accredited hospital.

Harvesting: We make an incision on the upper buttock, usually low enough to be hidden by standard underwear or bikini bottoms.
Transfer: The tissue is moved to the chest. If you are having a bilateral (double) reconstruction, we may take tissue from both sides.
Shaping: Gluteal fat is denser than abdominal fat, which often allows for greater projection. We shape it into a breast mound that mimics a youthful breast.
Closure: The donor site is closed, which results in a distinct contour improvement—essentially a butt lift effect.

Alternatives: PAP, LAP, and Stacked Flaps

If the upper buttock is not suitable, we have other options.

PAP Flap (Profunda Artery Perforator): Uses tissue from the inner thigh. This is excellent for small-to-moderate breast volumes and leaves a scar hidden in the groin crease.
LAP Flap: Uses tissue from the lumbar region (lower back/love handles).
Composite Stacked Flaps: For women who need more volume than one site can provide, we can stack multiple flaps (e.g., a DIEP and a PAP) to create a larger breast without implants.

We are a plastic and reconstructive practice that believes in a personalized approach. We do not force you into a single procedure; we tailor the treatment plan to your unique anatomy.

Recovery in Chandler

Recovering from sgap flap chandler surgery requires patience.

Hospital Stay: Expect 3 to 5 days in the hospital for vascular monitoring.
Positioning: You will need to avoid putting direct pressure on the buttocks for the first few weeks. We will teach you specific sleeping and sitting positions.
Mobility: Because we spare the muscle, walking is encouraged early. However, strenuous lower-body exercise is restricted for 6–8 weeks.
Follow-Up: All post-op care is handled at our Chandler office. Our office staff will help coordinate your appointments and answer any questions.

Cost and Insurance

Reconstruction surgery after mastectomy is covered by federal law (WHCRA). This includes the S-GAP flap, hospitalization, and surgery on the opposite breast for symmetry (such as a breast lift, reduction, or breast augmentation).

While we accept insurance, there may be out-of-pocket costs related to deductibles. We also work with financing partners to help patients manage expenses for cosmetic revisions or fat transfer procedures not covered by insurance.

Why Choose Southwest Breast & Aesthetics?

You do not need to fly to a coastal academic center for this level of care. Our American Board of Plastic Surgery-certified surgeons bring elite microsurgical capabilities to Arizona.

We are committed to women completely restoring not just a body part, but a sense of wholeness. Whether you are seeking a primary reconstruction or a revision of a past surgery, our team has the expertise to guide you toward an informed decision.

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S-GAP Reconstruction Frequently Asked Questions

Is the S-GAP flap safer than implants?

Safer depends on the timeframe. Initially, the S-GAP is a longer, more complex surgery than placing an implant. However, long-term safety favors the flap. Living tissue does not rupture, does not cause capsular contracture, and does not require the future replacement surgeries that breast implants inevitably demand.

Will I have a dent in my buttocks?

No. While we remove volume, we close the incision by pulling the surrounding skin and fat together. The result is typically a smoother, tighter contour, similar to a cosmetic lift. Most patients are pleased with the aesthetic improvement at the donor site.

Can I sit down after S-GAP surgery?

Not immediately. To protect the blood supply to the donor site (and the comfort of your incision), you will need to avoid sitting directly on your buttocks for about 2–3 weeks. We will teach you how to sit on your thighs or use specialized cushions during your recovery.

Does insurance cover S-GAP in Arizona?

Yes. Federal law mandates coverage for breast reconstruction, including the method your surgeon deems best for you. If you are not a candidate for a DIEP flap, insurance generally covers alternative autologous options like the S-GAP or PAP flap. We handle the pre-authorization process for you.

Can you combine S-GAP with a breast lift?

Yes. If you are having a unilateral (one-sided) reconstruction, we often perform a breast lift or reduction on the natural breast to ensure symmetry. This helps match the perkier, more youthful projection of the new S-GAP breast.

Better Begins Today

Your journey to better begins with a consultation at Southwest Breast and Aesthetics. Our plastic surgeons set the standards for plastic surgery through their innovative procedures and meticulous attention to detail. Discover a better experience by booking your consultation at Southwest Breast and Aesthetics today.

S-GAP Flap Breast Reconstruction in Chandler, AZ