Characteristics of the Inferior Gluteal Artery Perforator (IGAP) Flap in Breast Reconstruction

Until a year ago, the gold standard for breast reconstruction in the author's unit was the deep inferior epigastric perforator (DIEP) flap, followed by the superior gluteal artery perforator (SGAP) flap. Bob Allen then introduced the inferior gluteal artery perforator (IGAP) flap, and this was the first year experience of this flap.

Fourteen of these flaps have been done in 11 patients, with one failure. Two patients had a bilateral reconstruction, and in one patient two IGAP flaps were used to make one large breast. The patients who selected the IGAP flap tended to be younger and slimmer than the DIEP flap candidates. The author found that this flap took on average an hour longer to do than a DIEP flap because of lack of familiarity with the flap and because of the need to turn the patient on the table to inset the flap. The vessel sizes are different from the deep inferior epigastric vessels, and there is often a better match to perforators of the internal mammary vessels, if present.

Results and strategies that have been developed both for the operation and the postoperative recovery period were presented. The author believes that this is a very popular flap and is a much nicer flap than the SGAP flap in her experience.