SGAP: Results & Recovery

greenjay

I am planning on an SGAP at the NOLA center, and would love to hear from anyone who has had this procedure. Some of my most pressing questions are below, but please feel free to chime in any and all comments.

1) How long was your recovery from stage I, including the length of time the drains were in? (They say 6 weeks, but I know SGAP can be longer - 7, 8 weeks in some cases.

2) If anyone took longer than 6 weeks, how difficult was it to get back to work with drains in??

3) How much were your hips altered before stage II - mild, moderate, drastic?

4) If you had prior radiation, did this impact your results in any way?

5) 8 hours is a long time to be under anesthesia - how soon were you feeling back to normal?

thanks!

LAstar

Hi, greenjay:

1) It took 6 weeks to feel functional because I was on meds the entire time. At 8 weeks my drains had to come out, but then I had to have my seroma aspirated a few times over the next 6 weeks before Stage 2.

2) I work at a desk, so the drains didn't affect me. Nothing like getting them out though!!! Ahhh...

3) I had the classic "shark bites" where my hips looked like an 8 from the back. It wasn't that noticeable in clothes and I just wore longer shirts until Stage 2.

4) No radiation.

5) My surgery was 11 hours (BMX & SGAP). It took a week or more to shake off the anesthesia. They should give you a spirometer to help expel the anesthesia and it really helps. I would sit with a huge glass of water and my spirometer and make sure I used both regularly. As you breathe out the anesthesia, you can taste it, even a week later -- yuck!

Best of luck with your preparations!

besa

1) I got rid of my drains at 4 weeks and went back to work then. My job is not completely sedientary and I didn't want to go back to work with drains - though I did walk on the treadmill at the gym with them.

3) I had a smaller recostruction so only mild alteration to my hip.

4) No radiation.

5) For me it took a few days after being released from the hospital to feel the anesthesia was out of my system. I developed a very low fever a day or two after i was released from the hospital that lasted about a day. The docs told me I just needed to continue to use the spirometer and it would clear - which worked. After that I was feeling good enough to spend time walking around the French Quarter with my husband.

greenjay

Thanks so much!

LAstar: if you had to have aspirations, who did this? Did you fly back down to Nola or have this done locally?

Did stage II completely eliminate the 'shark bites'?

LAstar

I had asked my local BS if he would follow me when I got back in case of complication, so he or his PA did the aspirations. The shark bites disappear at Stage 2 when the butt lift is done -- yay for butt lifts!

Fe_Princess

Hi there, did anyone get excersizes to stretch the hip area and skin? I still feel like I am taped up. I hated those drains. I could not work with them. It did not help that I got a staph infection in my hip incision either. I had to go back into the hospital for five days a month after my SGAP:

greenjay

Fe Princess -

where did you get your surgery? New Orleans or locally where you are in Europe?

Also, when you said you could not work with the drains, do you mean you could not do your job with the drains in? Are you at a desk, or something else?

Fe_Princess

I had my surgery on April 14th. I had it done here in Zurich. I had my mx in Portland OR but have since moved here. I could not work with the drains in because they were too painful. The hip drain is what is so hard. It was too easy to snag it on things. I was just so worn out too from the surgery. It is intense. I do sit at a desk but move around a lot. I do not know anything about a 2nd stage though.

Flanneuse

I'm wondering how common it is for SGAP recon to cause sciatica or lower back or hip pain? I have scoliosis and am prone to sciatic issues already and am now getting a little worried about the possibility of an increase in issues after post-op. As my surgery date approaches I am finding myself more concerned about complications at the donor site. I would hate to "rob Peter to pay Paul," as they say. Any advice or reassurance from women who've been there is welcome!

Fe_Princess

There is always a risk with surgery. I had a quality of life issue with the implant and was not ready to have a breast missing. My solution was not another implant so I went with SGAP. I could not do diep because I do not have enough fat. There will be more pain with two incision sites but as with mx, it will heal over time. The risk at the donor site is rare. My case was super rare. I was not eating properly and had no protein i?my system so my incision could not seal up. I am feeling good today. It is just a much longer recovery period. How is your health in general?

greenjay

Fe Princess - my health is very good; I work out every day. I would imagine the hip drains are annoying, but hopefully, they are tolerable - they are only temporary.

That's one thing I'd like to hear about from everyone who had sGAP - how long the drains were in!

LAstar

Hips are juicy. Expect anywhere from 3 to 8 weeks! Compression is key. The donor sites are concave, so it helps to layer a washcloth or two in each divot under your compression garment to close that cavity so no fluid can accumulate. I had my drains for 8.5 weeks. You will feel so thankful when the drains come out. They are annoying and it's hard to wear anything cute while they are in.

greenjay

LAstar, how did you walk around with drains in for that long? Were they visible and was it terribly uncomfortable - i.e, scale of 1-10, 1 = almost forgot about them, and 10 = so annoying you couldn't keep your mind off them.

LAstar

You get used to the drains as much as one can, and they are only uncomfortable if they accidentally get tugged or if the drain-tube incisions get infected. Mine got a little infected and sore, but I used a little pain-relief triple antibiotic cream and it felt better within a day. I felt better when I was done with bandaging and put on my compression garment -- then everything was in place and not moving around. You have to be careful with your bulbs when you are showering or changing bandages to make sure you don't drop the bulb and then it swings from your hip and hurts, potentially injuring the incision a little. It's good to secure the drain tubes a little (without obstructing flow) to be sure they are not snagged on anything. I wore my husband's button shirts a lot because they were long and easy to take off. Also, the pants/skirts/capris with the soft foldover waist are great for keeping the tubes in place without restricting flow. Then they feel absolutely slinky when those drains come out! It's all doable, just a literal pain in the ass.

Fe_Princess

HI Greenjay, I had two hip drains. One came out three days after I got out of the hospital. The 2nd one came out a week later. I had complications healing from the surgery and contracted a staph infection a month out from my original operation. I had to have the drains in for another couple of weeks. Be sure to eat a high-protein diet before and after the surgery. I had very low protein levels due to being a vegetarian and my incision would not heal properly and that is how I was susceptible to infection. Like LAstar said, be careful not to let the drains get tugged or wet. It is only for a while but remember they are there.

greenjay

How do you shower if the hip drains cannot get wet?

LAstar

My PS let us shower right away. I was instructed to use several clean soapy washcloths throughout the shower and wring out soapy warm water to flow across the incisions, & definitely not touch them. They stay happier and less angry if they get a nice soapy rinse every few days.

julscol

Hello! To FLANNEUSE

I had SGAP surgery about 4 years ago and YES. The scar tissue and huge invasive surgery has caused LOTS of back pain, Sciatica etc. I am not sure it was worth it.

LizzyDT

Hi all, I am new to group. I have been diagnosed for the second time in two years. First time mastectomy (L) then healed up and thought about reconstruction. Went for the Diep flap 18 months after mastectomy. Then on to the balancing surgery 3 months later. They reduced my right breast so it would match my reconstructed one. However, when the tissue taken from my breast was sent to pathology, they found IDC.

Went to the PS and he says I am a good candidate for SGAP, now waiting for BS and PS to find a day they can do it. What surprised me though, is the PS said he would only take tissue from my butt on one side, leaving an indent. I don't know why I had it in my head, that he would even it out from both sides.

My question is: How big of an indentation does it leave in your buttock(I am large B, small C) cup. Does it cause a problem say, when you are wearing jeans? Is it terribly noticeable? Will I once again be unbalanced?

Any info or guidance would be very welcome.

LAstar

My breasts are DD to DDD. I had SGAP and then the butt lift at Stage II, but there is still a bit of an indentation in my profile if I turn at just the right angle. It's not noticeable at all in jeans and probably only noticeable to me in form-fitting clothes. I would want to be symmetric though, but I don't know if it's worth the additional surgery, risk of complication, and resulting numbness to deal with it. Plus, it's your last donor site should a complication occur. I had SGAP on both sides but one side developed necrosis. The blood vessels from the hips are apparently smaller than those from the belly, so SGAP has a slightly higher rate of complications than DIEP. My SGAP breast with necrosis shrunk over 2.5 years and I eventually had DIEP to replace. My surgeon only took one side of my belly until she was sure that I would not have complications, and then I had a second surgery for symmetry a few days later. All of these decisions really stink! I wish you the best in finding the most successful path for you.

greenjay

I have a B cup, and got hip flaps at NoLa. I am very happy with the results, but I have not yet had the stage II, so I can't tell you what the final 'dents' will look like. From pics I have seen from my surgeon, the final results are excellent and the dents are barely there at all.

The first stage of course leaves a big dent because all they do is take the tissue out and place it on the chest. I am confident that the dents will all but disappear in my case ...as with just a B cup, not much flesh came off my hips in the first place, so correctting the dent will not be that hard.

That said, I lost about one inch on each side so went from a size 6 to size 4 in jeans, meaning that yes, pants will not fit that great until you get stage II. I wear a belt and that's fine in most of my pants.

However I must say that even with the dent as is - and it won't be this way for much longer as my II surgery is coming in December - I am 1000x happier than with those horrible implants!

I also have slight necrosis, so I may lose some volume, but again, I am willing to put up with smaller breasts than to suffer the pain and danger of implants.

note - I could not get diep surgery because I don't have enough fat on my abdominal area.

The most important thing is that you can do is go to an experienced plastic surgeon. I drove 1000 miles to New Orleans to get it done and was glad I did.

<<My question is: How big of an indentation does it leave in your buttock(I am large B, small C) cup. Does it cause a problem say, when you are wearing jeans? Is it terribly noticeable? Will I once again be unbalanced?>>

LizzyDT

Thanks LAstar and greenjay for your helpful information. I guess it is not going to be as uneven in the end (excuse the pun) as I thought. Funny though, that my PS never said anything about a stage 2. So glad to know that and I should have guessed knowing that the Diep had a stage 2 as well.

I have the top notch PS in Toronto, thus the delay due to his schedule.

How do you find your SGAP breast compares to a Diep Flap ?

Thanks again!

LAstar

My SGAP & DIEP breasts feel and look the same. The only difference I've noticed is that I seem to lose weight in the DIEP breast sooner than in the SGAP breast, which seems reasonable since I lose fat in my belly well before I lose it in my hips.

SCGirl50

In July I attempted an SGAP but it failed due to in adequate blood vessels. The flap was never placed so I was left with a temporary implant. On Oct. 31st I had an SGAP using the other hip, followed by a stacked DIEP 3 days later on the other breast. The shapes of them are different but that will be addressed in Stage 2. I hate the way my bottom feels right now so I hope there will be some improvements next stage. I now have 8 incision scars since my diagnosis. I am feeling like the bride of Frankenstein.

valw

Just had SGAP Stage 2. I am in shock. Just saw new breasts. They are small flat almost B cups, with nothing on top of breast. Flat upper chest. Only B on lower pole of breast. Was a natural C cup and wanted C+ or D. So disappointed. Haven't seen surgeon for post-op visit yet. How can tell him that I can't believe that this is the result? Breast mound after Stage 1 was a C cup and lipofilling was supposed to increase that. What on earth can have happened and can this be fixed? Anyone come out much smaller in their Stage 2 revision?

Ad197

I, regretfully, had Bilateral Sgap (3 stages) also. My doctor thinks I look "great" and everything went as planned according to him. My insurance is a great disappointment as I cannot find a doctor that wants to take it and help me. I am now looking for a doctor that will fix me outside of my insurance as my buttocks is VERY disfigured. It is very expensive so I am looking outside the USA also. Not only do I have huge dents in my buttocks and no transition from my back to my buttocks, I also have a disfigured gluteal fold. Another micro surgeon told me "that was very common with the Sgap, but women don't complain about it" (Really?). I have never seen pictures that look how I now look (even my breasts were supposed to be bigger in stage 2 like valw).

I am looking for women that have gone through Sgap with the result of severe buttock deformities and got at least their buttocks reconstructed to fix the donor site damage as that is my main concern right now.

There has to be a way to fix my buttocks as I know I am not alone, but women are silent because it is HUMILIATING. I am very disappointed with the way I look so I am speaking out to help other women in need of Sgap surgeries tomake an informed decision. I feel my situation was 100% preventable had I been given honest information and realistic pictures by my doctor.

Ladies, please make informed decisions and demand pictures of women at all angles or even video that are equal to your body build and went through the same operations you are being told to do. He wouldn't show me pictures but I still went through with the surgeries because of his reputation.

Lula73

valw- you have every right to ask your PS what went wrong. Pull up his before & after pics and ask why you don't look similar. Just curious, where did you have your surgery/who is your PS?

Ad197

Valw - According to my doctor, everything went as planned and I looked how I was suppose to look at each stage of the process. I was repeatedly told to "trust him he has a lot of experience and knows what he is doing." If I was educated I believe that I would not have fallen for this scam. I don't want other women to be in my position. I have to pay to get myself fixed. If I knew that it was common to be disfigured by the Sgap, and that it is very expensive and difficult to fix, I would not have gotten it done. The doctor knew this but chose not to tell me the truth. That is not how the Sgap is marketed. My doctor assured me that I would not be disfigured and thinks I look "great." He told me that I was the first to complain about how I look. He also told me that "women seek him out for this look." I am severely disfigured. This whole experience has been so humiliating! I do not know why women don't speak up about this. Doctors just are not trustworthy so I believe that it is better to educate and share experiences than just name doctors. My doctor is fully aware of my concerns and situation. I have been open and honest with him throughout the entire process. He simply does not care and has not been truthful to me. I deserve to get fixed. I should not have been put in this position. This site has been very disappointing to me also.

I am looking for women that have gone through Sgap with the result of severe buttock deformities and got at least their buttocks reconstructed to fix the donor site damage as that is my main concern right now.

Fe_Princess

Hi Ad197,

I had a SGAP on April of 2016. I had a very disfigured buttocks from it. It didn't help that I got a staph infection in the donor site. I was hospitalized eight days because of it and it made the scar even worse! He tried to fix it with from lypo but that did not work either. The skin was ruined due to the infection. What finally ended up happening was the he lifted the skin over the scar and made a new one. My right cheek is more flat the my left one. I am not super happy about it but I cannot do much else. It is your right to demand a good looking but that gets disfigured from this surgery. I would have done DIEP but did not have enough fat there. If you want to pm me, please do and we can go further into it.

With love xoxo

Ad197

Fe_Princess -

Were you told that you were going to be disfigured from the Sgap before you consented to the procedure? Are you also looking for doctors that can reconstruct your buttocks? Are your gluteal folds (bottom of the buttocks) disfigured also?

I have already had the pants-over-vest fasciocutaneous flaps in stage 2, and my doctor told me I was done with reconstruction and looked great. I am severely disfigured and have no one to turn to. I do not believe there was any thought into designing my flaps. The surgery was a complete waste of time, money and resources.

I was told by another doctor that does Single Sgap that it is very common to also disfigure the gluteal folds when women get this procedure. He did not know how to correct it but told me women don't care how their butt looks, they just want breasts. I was told by 2 different doctors that regularly do Bilateral Sgap I would not be disfigured and I would get better results than with the DIEP. The way these doctors market the sgap is VERY deceiving and what I was privately told by these 2 different doctors also does not match what happened to me. I do not believe that I am the only one to be shocked about my disfigurement.

I am searching for a way to fix the gluteal folds which is my primary concern. I know a lot about buttocks reconstruction now. Doctors are taught NOT to violate, EVER, the gluteal folds, yet I am told it is regularly being done to Sgap patients. It could be avoided but the doctors don't care enough about breast cancer patients to update their techniques. Also, respectable doctors would not be so careless and make cuts on the buttocks if they were concerned with deformities. It is really difficult to reconstruct the buttocks if it is cut into and should be avoided. Doctors know this fact. I was lied to and told that I would not be disfigured. In fact, the doctor thinks I look great!

Breast cancer patients should get treated better than this.

LAstar

My surgeon at the Center in New Orleans did not disturb the gluteal folds in my SGAP. The only incisions were made higher up on the hips. Are you thin? They did NOT tell me about the higher risk of necrosis due to smaller vessels in the hip flaps. My left breast slowly shrank over 2.5 years due to the necrosis and I had to have a DIEP to replace it. My revisions were done my Marga Massey in Charleston -- she is amazing and I highly recommend a consultation if you can.