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GAP Flap Breast Reconstruction

What is GAP Flap Surgery?

GAP flap surgery uses a patient’s own tissue—specifically from the upper buttock area—to recreate a soft, natural-looking breast after mastectomy. GAP stands for “gluteal artery perforator,” the specialized blood vessels that supply the transferred tissue. This microsurgical technique avoids the use of implants and preserves all muscle, supporting long-term lower body strength and mobility.
The GAP flap is ideal for patients who don’t have enough abdominal tissue or have had prior abdominal surgeries that rule out other options.

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Key Information

  • Great option if you lack abdominal tissue
  • All-natural tissue—no implants needed
  • Tissue comes from upper or lower buttocks
  • No buttock muscle is removed—preserving strength 
  • Microsurgery ensures healthy blood flow
  • Performed by two experienced PRMA surgeons
  • Can include TruSense® to restore sensation
  • Most patients resume light activity in a few weeks
  • Typically covered by insurance, even for out-of-state patients
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What to Expect During GAP Flap Surgery

GAP flap breast reconstruction is a highly specialized microsurgical procedure performed under general anesthesia. During surgery, your team will carefully remove a section of skin and fat from either your upper (“superior”) or lower (“inferior”) buttock region while preserving all surrounding muscle. In either case, incisions are easily hidden with most underwear or bathing suits.

Using microsurgical techniques, your surgeons will then reconnect tiny blood vessels from the transferred tissue to blood vessels in the chest to restore blood flow and support healing. If you're having reconstruction at the same time as a mastectomy, both procedures are performed during a single operation. Otherwise, the GAP flap is done as a delayed reconstruction.

Once the breast mound is shaped and positioned, your surgical sites will be carefully closed. You’ll wake up in a recovery room, where your vital signs, blood flow, and comfort are closely monitored by your care team. Most patients stay in the hospital for 2 to 3 nights following surgery to ensure optimal healing and support.

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Before & After

See real results from women who’ve trusted PRMA with their reconstruction journey.
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Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
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Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
Before img-1
Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
Before img-1
Before img-1
Procedure: Bilateral Mastectomy with Immediate High Definition DIEP Flap Breast Reconstruction
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Recovery Timeline

  • Week 1:
    You’ll spend the first few days recovering in the hospital, where our team closely monitors blood flow to the flap, pain levels, and wound healing. Surgical drains will be in place, and you’ll begin walking short distances to promote circulation.
  • Week 2:
    Once home, you’ll continue caring for your incision sites and drains (if still in place). Most patients experience fatigue and soreness in the chest and buttock areas, but begin feeling stronger each day. Light walking is encouraged.
  • Week 3:
    Swelling and discomfort typically improve. You may be cleared to stop using drains by this point. Most patients are still avoiding strenuous activity but are more mobile and independent in daily routines.
  • Week 4:
    By the end of the first month, many patients return to work (if their job isn’t physically demanding). You'll have follow-up visits to assess healing, and discussions around sensation, scar care, and next steps (like nipple reconstruction or revisions, if desired) may begin.
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The Nation’s Destination for Sensation Restoration

PRMA has transformed breast reconstruction with their revolutionary TruSense® procedure, a proprietary technique that restores breast sensation in qualified patients—giving back not just form, but feeling.
About TruSense®

Am I a Candidate for GAP Flap Breast Reconstruction?

Each woman’s body and goals are different. During your consultation, PRMA’s team will carefully evaluate your health history, anatomy, and personal preferences to determine whether GAP flap—or another reconstruction option—is the best fit for you. 

You may be a strong candidate for GAP flap breast reconstruction if:

  • You’ve had a mastectomy or are planning one.
  • You do not have enough abdominal tissue for DIEP flap reconstruction.
  • You prefer a natural tissue option over implants.
  • You are thin, physically active, or have had previous abdominal surgeries.
  • You are in overall good health and able to undergo a longer microsurgical procedure.
  • You want to preserve muscle strength and avoid donor-site complications.
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Find Your Surgeon

PRMA is one of the few centers in the country with extensive experience in this complex microsurgical technique. Our surgeons treat patients from across Texas, the US, and internationally. We are proud to have a tremendous global reputation for breast reconstruction excellence.
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Dr. Minas Chrysopoulo
Championing Advanced Breast Reconstruction Access Nationwide
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Dr. Gary Arishita
Dedicated to Restoring Confidence Through Expert Reconstruction
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Dr. Oscar Ochoa
Board-Certified Plastic Surgeon & Fellow of the American College of Surgeons (FACS)
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Dr. Gary Arishita
Dedicated to Restoring Confidence Through Expert Reconstruction
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Dr. Oscar Ochoa
Board-Certified Plastic Surgeon & Fellow of the American College of Surgeons (FACS)

Will Insurance Cover GAP Flap?

GAP flap breast reconstruction is typically covered by insurance. Under the federal Women’s Health and Cancer Rights Act (WHCRA), all group health plans that cover mastectomy are also required to cover breast reconstruction, including natural tissue options like GAP flap.

PRMA is in-network with many major insurance providers and works with patients from across the country to navigate approvals and maximize coverage.

For more information, visit [Insurance FAQs] in the patient resource center.

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Preparing for Surgery

Many of our patients travel from out of town for GAP flap surgery. Our team will walk you through every step, from pre-op planning to travel arrangements, to ensure a smooth and supported experience.

Learn more about:

Preparing for Surgery
Travel Accomodations

Frequently Asked Questions

Why choose GAP flap over other flap options?
GAP flap is ideal for patients who can’t use abdominal tissue due to low volume or prior surgeries. It offers a natural result without using implants and preserves all muscle for easier recovery. For the right patient, it’s a powerful alternative with equally long-lasting outcomes.
What are the risks and side effects of GAP Flap?
GAP flap surgery is safe when performed by experienced microsurgeons, but like all surgeries, it carries risks. These can include bleeding, infection, delayed wound healing, asymmetry, and fat necrosis. PRMA’s dual-surgeon technique and enhanced recovery protocols minimize these risks significantly.
How long will I be in the hospital?
Most patients stay in the hospital for 2–3 nights following GAP flap surgery. This allows for close monitoring of flap health, pain control, and support with mobility.
Will I lose muscle or strength in my buttocks?
No. The GAP flap procedure is muscle-sparing, meaning all your gluteal muscles are preserved. This supports a faster recovery and long-term strength.
Is GAP flap covered by insurance?
Yes. Most insurance providers cover GAP flap reconstruction under federal law. Our team will help you navigate the approval process and confirm coverage details.

Look and Feel Like You Again.

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