S-GAP Questions

TooQuiet

Hi!

I'm facing a plastic surgery decision, and I'm looking for anyone willing to answer any of my S-GAP questions.

I've had a lumpectomy and a re-excision without clear margins, so my next surgical step (after completion of chemotherapy) is a unilateral mastectomy with immediate reconstruction. I saw a plastic surgeon yesterday, and I don't have enough body fat for DIEP or TRAM reconstruction. He can do an implant, but I have plenty of time, so he suggested getting a second opinion from one of the teaching hospitals about two hours away, where the surgeons are skilled in GAP reconstruction. I might be a candidate for the S-GAP procedure, but I have concerns regarding the donor site and any negative effect the procedure might have on running or hiking. So my questions are...

1. Were you happy with the cosmetic result at the donor site?

2. Did you lose sensation at the donor site, and did it return (fully or partially)?

3. Would you have been able to travel two hours by car for your post-surgical follow-ups?

4. If you are an active/athletic person who underwent S-GAP, did you see any negative long-term effects on your gait or lower-body strength (I understand there's no muscle involvement in this procedure - I just haven't found very much information on long-term effects and am curious)?

5. How long after surgery was it before you could run/hike/bike again?

Thank you so much!

FLBuckeye93

Cntact the Breast Center in New Orleans. They specialize in SGAP. I'm considering it, too, and will go to them for surgery.

Lula73

ditto FLBuckeye's response. Here's the website for the docs in NOLA: www.breastcenter.com. Every center/doctor has different outcome results. Check their before and after photos closely before deciding. Additionally your insurance may cover you going to NOLA even if they are out of network since it sounds like these other docs are "out of area". As far as traveling forfollow up appointments post-op, NOLA sees you 7 days post-op then you're good to go.

TooQuiet

I will look into NOLA. Thank you for the advice!

RebzAmy

Hi, I had an IGAP, which is very similar. This was now some years ago - in fact I had two and they were in 2010 and 2012. I have lost feeling in the back of one leg as they had to cut one of the nerves as it was so tangled up and also the back of the other leg has some feeling as the nerve was also damaged. In terms of strength, that's not been affected at all. They cut in the crease of my butt but as mine was an IGAP it's in a slightly different position to the SGAP and yes I have scars but they do fade after a while. I also had liposuction to use fat from my leg to fill my breast afterwards during revision surgery. The actual reconstruction looks amazing. I'm a bit conscious of my scars now on my butt area. I also am more sensitive in that area, in terms of less fat/padding to a bit more sensitive and in fact I used to do spinning and find bikes more uncomfortable now and I need a gel seat.

Lula73

SGAP has distinct advantages over IGAP because you don't lose the sensation in the back of your legs, you don't compromise the muscles and nerves in the back of your legs,and retain all your cushion for comfortable sitting. I like to say The SGAP takes your love handles and does not compromise your musculature in your legs and butt :-)

besa

I had sGAP surgery at NOLA and am happy with my results and am active with no physical limitations. When I looked into the possibility of having sGAP locally (for me DC, MD, VA area) I could not find anyone who was doing more than about one sGAP/month' (also residents and fellows would be perticipating in those surgeries which I did not want.)

The NOLA docs do multiple hundreds/year and 2 experienced plastic surgeons (not residents or fellows in training) work on you together so the o.r time is cut way down.

Important -You want a plastic durgeon who is VERY experienced (done many of these surgeries when not in training) who has a large group of happy "customers" who are more than willing to talk to you and even show you their results in person.

Has anyone talked to you about possibly being a candIdate for a "stacked" DIEP? This might allow you to still use your tummy donor site. My understanding is that with a plain regular diep only about 1/2 of the tummy donor tissue can be used per reconstructed breast. In a stacked diep both halves are used to construct one breast.

A stacked diep is a surgery that requires more skill because of the way the blood vessels are attached to the recipient site in the breast. The nola plastic surgeons are able to do this but many plastic surgeons are only able to do the simple diep surgery. See the link to the nola web site above.

Fe_Princess

I had a S-GAP in May 2016. I had my mx on March 31st of 2015 with a tissue ex pander a reduction of the other breast. There was not enough skin left over to allow for the implant. The implant started to move up my chest and was making my arm numb and developed cloister phobia from the implant under my pectorial muscle. I S-GAP is an intense surgery with a long recovery time too. I am glad I had it done but I developed a staph infection in the donor site so bad that I had to re-hospitalized with it for eight days which prolonged my recovery and ruined the skin along to incision. There is a huge indentation form it that it very noticeable and I am very self conscious of it. Forward to t year later and I had fat removed to reshape the breast which has turn out perfectly. They tried to fill in the gap with more fat. (done with lypo) but it did not really make a big difference. Getting lypo is super painful too. They will now basically bring the butt up just over the wounded scar and make a new one which with also fix the indent part. It has been quite a journey. I am glad that I did in even in hindsight. I was not initially happy with the outlook as I still hold my old look in my mind but patience is of most importance in these time. I have numbness but only in my scars and not much beyond. The feeling will come back but not 100%. I am very active and once I was recovered, I was back to my running, hiking, and cycling. I should think that two hours is comfortable enough. I would bring pillows or find a perfect posiiton before your travels starts.

I received my deip in Switzerland.