GAP flap without implants. Any experience?

I want to have a reconstruction later this year (both sides) but I’m quite slim so the Trans flap option isn’t available to me. I’ve been reading about the GAP flap option where they use tissue from the buttocks instead and this can result in no implants as well, which is a more preferable option for me. Trouble is I can’t find out where is best to do this and which surgeon will do it. Can anyone help?

Hi Pennies,

I had an IGAP flap done in January 2009 - the IGAP is using the lower part of the bottom, ie in the natural crease of the buttock. I didn’t have an implant and am very pleased with the result. I had it done by at the Norfolk and Norwich hospital - she does see people from outside the area but is very busy. She has done both of my reconstructions (I had a DIEP done in April 2007, but needed an implant as well).

is excellent, has a great reputation and I can’t recommend her highly enough. If you have any questions, please don’t hesitate to ask away, either in this thread or by pm.

Sally .

Hi Sallylou and Pennies,

Sorry to jump in on your thread Pennies as I don’t have any experience to help you, but am interested in your thread as I am seeing a surgeon next week to discuss delayed reconstruction. From reading the literature, I’d like to find out about the DIEP and IGAP/SGAP options. But like you Pennies, from what I can find out not as many hospitals offer the IGAP/SGAP so was wondering too if anyone had experience of this surgery.
Sallylou, you have had the two options that I seem to be considering most…do you mind me asking how have you found the different recons, any preference/suggestions in your experience?

Hi Gerbera,

I have to say with hindsight, I would choose the IGAP surgery over the DIEP, purely based on the recovery. The DIEP is a longer op and it takes a long time to recover from the tummy tuck aspect of it, as you can’t stand up straight for a week or so, can’t carry or lift anything heavy and, in my experience, was quite painful. However, the IGAP recovery was much quicker - I had to keep my leg straight until the wound was fully healed which was about 10 days. Walking up and down stairs was a bit tricky, and I did learn to wee standing up which was quite funny really. When sitting down, I just kept my leg raised on a foot stool. Also, the scar on my bottom, although about a foot long, is barely noticeable as it’s hidden in the crease and my DIEP scar is still noticeable - looks a bit like a shark attack scar!

Hope this helps,

Sally x

Hi Sally,

Thanks very much for sharing how you have found the different reconstructions, it’s so helpful. I’ve been referred to a plastic surgeon and have an appt this week, but from the info I’ve been given I don’t think he does IGAP, just DIEP, so may be will be researching where I could be referred to!

Pennies, how are you getting on, have you had any progress in finding where to go?

Siobhan x


Thank you for all the information posted on this thread.
I am waiting for a date to have an IGAP at the Norfolk and Norwich Hospital. I have had a double mastectomy 3 years ago and have decided now to go for recons. This lady surgeon at NNH comes highly recommended and she gives me a lot of confidence already. The breasts will be reconstructed during two separate operations allowing a recovery of 3 to 6 months between operations.
I am nervous but I am really looking forward to it, hoping to feel life will be more like it used to be.

Any more tips and advise will be most appreciated.

Thank you.


Hi Paola,

Sounds like you’re having the same surgeon that I had - just can’t mention her name on the thread! Don’t be nervous, she’s really great and she’ll get the best result she can for you.

As far as tips and advice go, get plenty of rest and do everything she tells you to; she knows what she’s talking about!

Good luck!

Sally x

Hi, I am new to the forum. I had breast cancer in April 2008 and a risk reducing second mastectomy and bilateral LD reconstruction a year later with lipofilling as I did not want implants. The problem is that the surgeon did not make a particularly good job and I am very twitchy and lopsided (he has operated again to try to reduce the twitching, to no avail). We have recently moved house and I have been referred to a new surgeon who has suggested starting completely from scratch and doing a bilateral IGAP reconstruction. She seems very keen to do this, but has never done the operation before. She says she is confident that she can make a good job and will go and watch a highly competent lady in Chelmsford first. I am told the operation will take 10-12 hours and that her colleague is also very good.

The alternative that she suggested would be to do much more lipofilling and operating to correct the shape of what I already have and tidy up uneven scars and to try to reduce the twitching again.

The difficulty is that I have three children (youngest 12) who have already seen me undergo a lot of traumatic treatment and that this is a long, hard procedure. Do I opt for several small, patching up operations which would be shorter and with less recovery time, or do I hit the problem once more with one very big op and possibly some small revisions? I feel a bit guilty about putting my family through more stress for what is now, I suppose, a problem of personal vanity. What are other people’s views?