DIEP / SGAP Flap
Breast Reconstruction


Unique Opportunity in San Diego at Our Practice:

Advanced Breast Reconstruction Provides Natural-Feeling Breasts and the Benefits of Tummy Tuck, with No Muscle Loss

Did you know that plastic and reconstructive surgeons can rebuild your breast(s) after mastectomy using your own tissue? This is known as autologous flap surgery. The surgeon takes a section of skin, fat, tissue (and in some cases, muscle) from another area of your body and moves it to the chest to construct the new breast. There are numerous advantages to this approach: the results are very natural in look and feel. It is easier to match the symmetry and dimensions of your natural breast with your own tissue than with an implant. Also, with flap reconstruction, there is not the risk of the body rejecting an artificial implant. And, the area from which the flap is taken will simultaneously undergo cosmetic enhancement. The success rate with flap reconstruction is very high.

While there are several types of flap procedures available for breast reconstruction, SGAP and DIEP are two of the most advanced options. Only truly qualified plastic and reconstructive surgeons are able to offer reconstruction with the SGAP and DIEP flaps, and Dr. Anshu Gupta is one of them. During consultation, Dr. Gupta will determine whether you are a suitable candidate for flap surgery and, if so, educate you about your options. He will evaluate the pros and cons of each approach and help you make an informed decision about how to move forward.

DIEP / SGAP Flap Patient
42-year-old female patient with history of breast cancer, mastectomy, chemotherapy, and radiation who wished to proceed with breast reconstruction. First stage reconstructed with deep inferior epigastric perforator (DIEP) flap. Second stage reconstructed with submuscular silicone gel implant and crescent scar breast lift to the contralateral side. 350cc smooth round moderate plus profile implants used. Photos show post mastectomy, pre DIEP flap, pre nipple reconstruction, post nipple reconstruction, and post nipple tattooing.

More about the DIEP Flap

Comprised of skin, tissue and blood vessels from the lower abdomen, a deep inferior epigastric artery perforator (DIEP) flap is used to rebuild the breast mound. In addition to the reconstructive benefits of the flap procedure, it also provides a tummy tuck effect that is greatly appreciated, as many women have surplus fat and skin on the lower abdomen. The abdomen looks flatter after DIEP flap surgery.

The DIEP flap is a “free flap” technique, meaning the tissue is removed from the abdomen and reattached to the chest area (as opposed to tunneling the flap underneath the skin). The blood vessels from the abdominal tissue are reattached to the blood vessels in the chest so the flap can develop its own blood supply and thrive. The abdominal tissue is then shaped into a natural looking breast.

Some reconstructive surgeons prefer the DIEP flap to the similar transverse rectus abdominis myocutaneous (TRAM) flap, which removes fat, skin and muscle from the same area. Because the flap includes the muscle, TRAM flap surgery has been linked to decreased abdominal strength and the risk of hernia, and does not provide the true look of a tummy-tuck.

The DIEP flap keeps the abdominal muscle in place, therefore preserving abdominal strength, reducing the risk of hernia and leading to less post-operative discomfort, greater aesthetic results and shorter overall recovery.

More about the SGAP Flap

A superior gluteal artery perforator (SGAP) flap, which is comprised of skin, tissue and blood vessels from the top of the buttocks, is a flap used to recreate the breast. The gluteal muscles are not removed or altered during SGAP flap surgery. Tissue can be harvested from each buttock for symmetrical results.

SGAP is a suitable alternative if DIEP flap is not advisable, either because of insufficient abdominal tissue/skin or previous abdominal surgery that has interfered with the blood vessels. SGAP is less common than DIEP flap surgery, as tissue from the buttocks can be more difficult to shape into a natural looking and feeling breast. However, it is a viable possibility and has been successful for many breast reconstruction patients. It may also be a better option for women seeking a buttock lift.

Once again, there are only a handful of qualified plastic surgeons in the country offering this procedure and Dr. Anshu Gupta is proud to offer this option to San Diego County.

Refining the Results of Breast Reconstruction

Breast reconstruction with a DIEP or SGAP flap can be refined with creative techniques like fat grafting to smooth out the final result and help the reconstructed breast look and feel as natural as possible. Also, the nipple and areola can be reconstructed, either through tissue grafting or advanced tattoo techniques. Dr. Gupta can explain these possibilities with you during consultation.

Schedule a Breast Reconstruction Consultation

For more information about breast reconstruction with the DIEP or SGAP flap, please contact Dr. Anshu Gupta at Verve Plastic Surgery. Call (760) 436-7600 to book an appointment.