The Sc-GAP makeover flap: eliminating the need for position changes in gluteal flap breast reconstruction

Ennie Bijkerk, Rene R. W. J. van der Hulst, Arno Lataster, Stefania M. H. Tuinder*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background The gluteal region is one of the many alternative donor sites for autologous breast reconstruction. However, the harvest of the gluteal flap is rather difficult, and the major drawback of gluteal flaps has been the need for position changes for flap harvest and inset. A new approach of a gluteal flap is introduced, based on the septocutaneous perforators of the superior gluteal artery: the septocutaneous gluteal artery perforator (Sc-GAP) makeover flap. Methods A prospective study was performed in Maastricht University Medical Center between January 2018 and December 2019. Patients who underwent a Sc-GAP makeover flap breast reconstruction in the Maastricht University Medical Center and have had preoperative magnetic resonance angiography (MRA) of the abdomen between January 2018 and June 2019 were included. Results Nine patients underwent breast reconstruction with thirteen Sc-GAP makeover flaps, of which nine flaps were innervated. Indications were the abdomen not being available as a donor site (n = 4) or the flank region was preferred as a donor site by the patient (n = 5). The total operative time was 430 min on average (range 311-683). Mean flap weight was 638 g (range 370-1004) and the mean ischemia time was 53 +/- 9.96 min. Coupler size used was 2.0-2.5 mm. All flaps survived. Conclusion The Sc-GAP makeover flap overcomes the disadvantages of the conventional gluteal flaps, especially by eliminating the need for position changes during the reconstruction procedure. It is a reliable flap that provides sufficient volume and good esthetic outcomes. Level of evidence: Level IV, therapeutic study.

Original languageEnglish
Pages (from-to)379-388
Number of pages10
JournalEuropean Journal of Plastic Surgery
Issue number4
Publication statusPublished - Aug 2020


  • Breast cancer
  • Autologous breast reconstruction
  • Gluteal flap
  • Septocutaneous perforator
  • Superior gluteal artery


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