A second superior gluteal artery perforator flap with previous liposuction to the same breast after resection of initial SGAP breast reconstruction due to cancer recurrence
ABSTRACT Free superior gluteal artery perforator (SGAP) flaps are a reliable option for breast reconstruction in patients with insufficient abdominal tissue or abdominal scarring. Liposuction in a donor site is a relative contraindication for harvesting a free flap, despite current case reports challenging this tenet. We describe a case of a 36-year-old woman who underwent unilateral breast reconstruction with free SGAP flap. She underwent liposuction of the contralateral buttock for symmetry. Approximately, one year post-operatively, she developed local recurrence of the breast cancer. Previously liposculpted buttock was used as donor site for a second free SGAP flap anastomosed to internal mammary artery. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.
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ABSTRACT: Fujino was the first to introduce gluteal tissue as a free flap for breast reconstruction. The use of the musculocutaneous flap from the buttock in breast reconstruction has been championed by Shaw. Despite the initial enthusiasm for this area as a donor site, few other large series exist on the subject. Two decades of experience with this region as a donor site led to recognition of advantages and drawbacks. Furthermore, use of both the superior and inferior gluteal musculocutaneous flap was associated with certain important donor site complications and the use of vein grafts to allow for microvascular anastomosis. The evolution of free tissue transfer has progressed to the level of the perforator flap. This reconstructive technique allows elevation of tissue from any region consisting only of fat and skin. This minimizes donor site morbidity by allowing preservation of the underlying muscle and coverage of important structures in the region such as nerves. The superior and inferior gluteal perforator flaps have been used at our institution for breast reconstruction since 1993. The superior gluteal artery perforator (S-GAP) flap is our preferred method of breast reconstruction when the abdomen is not available or preferable. We report the result of this flap over the past 9 years and point out important surgical refinements, advantages, disadvantages, and lessons learned during this time.Annals of Plastic Surgery 03/2004; 52(2):118-25. DOI:10.1097/01.sap.0000095437.43805.d1 · 1.46 Impact Factor
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ABSTRACT: The gluteal region is an excellent donor site for autogenous breast reconstruction, particularly when the lower abdomen is not suitable. The superior gluteal perforator flap involves microsurgical transfer of skin and fat from the buttock without muscle sacrifice. Gluteal myocutaneous flaps have been described, but they have several problems, including a short vascular pedicle, exposure of the sciatic nerve, and recipient vessel size discrepancy needing vein grafts.Clinics in Plastic Surgery 05/1998; 25(2):293-302. · 1.35 Impact Factor
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ABSTRACT: The purpose of this paper is to present a new method of breast reconstruction utilizing skin and fat from the buttock without muscle sacrifice. Cadaver dissections were done to study the musculocutaneous perforators of the superior gluteal artery and vein. Eleven breasts were reconstructed successfully with skin/fat flaps based on the superior gluteal artery with its proximal perforators. Long flap vascular pedicles allow the internal mammary or thoracodorsal vessels to be used as recipient vessels. This new technique has several advantages over the previously described gluteus maximus myocutaneous flaps, including long vascular pedicle and no muscle sacrifice.Plastic & Reconstructive Surgery 07/1995; 95(7):1207-12. DOI:10.1097/00006534-199506000-00010 · 3.33 Impact Factor