SGAP Breast Reconstruction: Backside to Front Side


TAMPA, Fla. (Ivanhoe Newswire) — Patients who aren’t candidates for traditional breast implants now have another option, if they’re willing to say goodbye to some of their buttocks.

Stacey Nance manages a mega mall: the Tampa Premium Outlets.

“Everything from the roof all the way down to the ground is my responsibility,” Nance told Ivanhoe.

But managing her health lately has also been a full-time job.

Nance said, “I’ve had such extreme surgeries and such procedures and trying to recover.”

Here’s why: Nance tested positive for the BRCA1 gene, so she had a double mastectomy, then breast reconstruction where her backside played a big part.

“I had never heard of it,” Nance said.

Luckily, Raj S. Ambay, MD, DDS, a Board-Certified Plastic Surgeon and Florida Hospital Surgeon had. He recommended a procedure called SGAP: superior gluteal artery perforator.

(Read Full Interview)

“You’re using tissue that most people are happy to get rid of,” Dr. Ambay said.

Dr. Ambay says he takes excess tissue from the buttocks. Then a breast is made from that tissue.

“We only take the skin and fat and we dissect these tiny little perforators. They’re almost like the size of a tip of a ballpoint pen and then we remove that tissue, make a breast on the back table at the same time the surgeon is removing the breast for the mastectomy,” Dr. Ambay explained.

Doctors then carefully reconnect all the blood vessels. Nance says it took two 12-hour surgeries.

“Everything is very natural. You know I don’t have a foreign object in my body.” Nance said.

Dr. Ambay says pain is minimal because he doesn’t take out nerves or cut the muscle.

“Modern medicine at its finest absolutely,” Nance said.

Helping patients regain their good health and get back to work after surgery.

The first 24 hours after procedure patients need to be checked making sure vessels connect. Dr. Ambay says there’s less chance of infection because it utilizes that patient’s own tissue.

Contributors to this news report include: Emily Maza Gleason, Field Producer; Chris Tilley, Videographer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.

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REPORT:       MB #4511

 BACKGROUND: Women who have had surgery to treat breast cancer can choose from several types of breast reconstruction. Sometimes the process means more than one operation. Two main types of operations can be done to reconstruct the shape of your breast or breasts: using silicone or saline breast inserts (known as breast implants) or using your own body tissues (known as tissue flap procedures). Sometimes the implant and flap procedures are used in combination to reconstruct a breast. Also, nipple/areola tattooing and fat grafting can be done to help make the reconstructed breast look more like the original breast. The reconstructed nipple and areola do not have any sensation.


SGAP: The superior gluteal artery perforator (SGAP) flap uses tissue from the top of the buttocks to create breast tissue. This is usually done if patients do not have adequate skin and tissue in their abdomens or have had previous abdominal surgeries that may have interfered with blood vessels that the flap requires. When the breast is reconstructed entirely with your own tissue, the results are generally more natural and there are no concerns about a silicone implant. In some cases, you may have the added benefit of a “bottom lift” or similar cosmetic surgery. For many patients who have had abdominal surgery, SGAPs are the best route to reconstructing a breast that looks and feels similar to the way their breasts felt before cancer treatment.


CANDIDATES: SGAP surgery is more technically difficult than other flap procedures and usually takes more time to do. There are not many plastic surgeons who are trained to do it, so you may have to search for one if you’re interested in this procedure. An SGAP flap may be a good choice for thin women who don’t have enough extra belly tissue. If you’ve previously had liposuction on your buttocks, you may not be a good candidate for SGAP/hip flap reconstruction because you may not have enough extra tissue available.



Ashley Jeffery


If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

Doctor Q and A

Read the entire Doctor Q&A for Raj S. Ambay, MD, DDS, Board Certified Plastic Surgeon

Read the entire Q&A