Using tissue from the thighs or buttocks

Breasts can be reconstructed using fat and skin taken from your buttock or thighs. These operations may be suitable for you if you want breast reconstruction using your own tissue but are very slim, or have scarring on your tummy from previous surgery. They are complex operations and not all breast reconstruction centres do them. They take about 6-8 hours.

Reconstruction using tissue taken from another part of your body will mean you have a scar on your breast(s) and on another part of your body. The breast(s) will feel look and feel natural but may be numb or less sensitive than natural breasts.

Fat and skin can be taken from your upper buttock or lower buttock to make a breast shape. Or tissue including some muscle can be taken from your upper inner thigh.

Reconstruction using tissue from other areas of your body

Breast reconstruction can be done using tissue from other areas of the body. The most common areas are the buttock or the inner thigh. It may also be possible to take flaps from other areas where there is enough fat and a suitable blood supply.

These operations are less common and not all breast reconstruction centres do them. They may be suitable if you want a reconstruction using your own tissue but are very slim or have scars on your tummy from previous abdominal surgery.


Tissue taken from your buttock

Sometimes a new breast is made using fat and skin taken from the buttock. This may be done when the tummy area can’t be used, perhaps due to scarring from previous operations. Or it may be because there is not enough tummy tissue for reconstruction. It involves complex surgery and a long operation (6–8 hours).

There are two different operations that use tissue from the buttock:

  • Free SGAP flap (superior gluteal artery perforator flap) – tissue is taken from the upper buttock.
  • Free IGAP flap (inferior gluteal artery perforator flap) – tissue is taken from the lower buttock area.

SGAP-flap reconstruction(front)
SGAP-flap reconstruction(front)

View a large version

Read a description of this image


SGAP-flap reconstruction(back)
SGAP-flap reconstruction(back)

View a large version

Read a description of this image


Benefits

  • The reconstructed breast looks and feels natural.
  • Two breasts can be reconstructed using this procedure.
  • There is no need for an implant.
  • There is no weakness in the back or tummy afterwards.

Limitations

  • You will have an oval-shaped scar on your breast and a scar on your bottom. An SGAP leaves a diagonal scar on the upper buttock, which can usually be hidden by underwear with a higher waistband. An IGAP scar may be hidden in the crease between the lower buttock and thigh.
  • One buttock may be slightly smaller than the other after the operation.
  • The reconstructed breast will have less sensation than the original breast (it will feel numb).
  • This type of reconstruction involves complex surgery and a long operation (6–8 hours).


Using tissue from your thigh (TUG flap)

This operation uses tissue from the upper inner thigh, including some muscle. The tissue is removed and attached to the breast area using microsurgery. It is called a free TUG flap because the upper gracilis muscle is used in the operation and the skin is taken from across your thigh (transversely). It involves complex surgery and a long operation (6–8 hours).

It may be suitable for women who are slim and have small breasts, as there is not usually enough tissue on the thigh for larger breasts. As well as a round scar on the new breast, there will also be quite a long scar on the thigh after the operation. However, this is usually well hidden because of its position.

Your surgeon may discuss other procedures with you that aim to achieve the best possible appearance for your reconstructed breast(s).

Back to Types of breast reconstruction

Surgery to the other breast

Some women have an operation on their natural breast so that the reconstructed and natural breasts look as similar as possible.