Like most reconstructions, this procedure can be performed as an immediate or delayed reconstruction. Patients are placed under general anesthesia or IV sedation during the surgery. 

During a GAP Flap, excess fat and skin is harvested from either a patient’s upper or lower buttock region or both (bilateral GAP Flap). These are referred to as a Superior Gluteal Artery Perforator (sGAP) Flaps and Inferior Gluteal Artery Perforator Regardless (iGAP) Flaps, respectively. However, regardless of the donor site, the incisions can be easily hidden with most underwear and bathing suits. 

During the procedure, the surgeon removes a portion of skin and fat—along with the connecting blood vessels—from either the lower or upper gluteal region, and transfers it to the breast mound, in order to form a new breast using microsurgical techniques to minimize scarring. During this flap procedure, no muscle or nerves are removed from the buttocks, allowing for maintained function and sensation of the area.  Due to risk of complication, patients undergoing bilateral GAP Flap reconstruction typically have only one breast reconstructed at a time.

Recovery

After the procedure, patients see results immediately, and must remain in the hospital for 2-4 days. Many patients can begin to walk without assistance 3 or 4 days post-procedure, and can return to all necessary activity once they return home. 

Most patients have three to four surgical drains placed in their incision sites, depending on whether they had one or both breasts reconstructed. Patients often resume normal daily activity 4-6 weeks after their surgery. Soreness often subsides after a week, and surgical scars start fading after 3 months and continue to improve up to a year after the reconstruction.