Achieve Natural-looking Breasts with SGAP Flap Reconstruction 

Breast reconstruction patients may choose to have a superior gluteal artery perforator (SGAP) flap reconstruction that harvests tissue from the upper buttock area and transfers it to the chest to transform the breast. Board certified reconstructive surgeon Dr. Oren Lerman in Manhattan, NY, can help determine if SGAP flap reconstruction is the right method for you. Dr. Lerman is the director of breast reconstruction at Lenox Hill Hospital's Institute for Comprehensive Breast Care, and is highly trained in a range of breast reconstruction modalities, including microvascular techniques.

The Procedure

Illustration of the upper buttock area used in superior gluteal artery perforator (SGAP) flap reconstruction surgery.During your SGAP procedure, Dr. Lerman will make an incision just beneath your back in the upper buttock area. He will remove fat, muscle fibers, and blood vessels from the harvest area. This elliptically-shaped flap of tissue will then be implanted into a pocket of your chest. Microsurgery techniques will be used to suture together the veins and arteries, effectively grafting your donor blood vessels into your chest. The breast tissue will also be molded into an aesthetically-pleasing shape. 

The Advantages

Unlike other flap procedures, SGAP donor site incisions and scarring are placed beneath the underwear line for optimal concealment. Dr. Lerman will utilize muscle- and nerve-sparing techniques as a means to limit damage to the donor site. 

Additionally, whereas some flap procedures can leave an indention where muscle tissue is removed, that is not necessarily so with SGAP flap procedures. When an SGAP procedure does affect the harvest site, it may actually have a positive outcome in tightening the skin around the buttocks, creating a youthful-looking lift.

SGAP flap reconstruction advantages include concealed scarring, minimal to no donor site contouring, and breasts that look and feel natural.

SGAP flap procedures offer the superior benefit of reconstructing the breast entirely with your body’s own tissues. This means there is no chance of tissue rejection, and breasts will appear and feel natural, especially when compared to reconstruction with breast implants.


If you identify with any of the following characteristics, an SGAP flap procedure might be suitable for your needs:

  • You have undergone or are planning to undergo a mastectomy
  • Your breasts have been damaged due to lumpectomy or radiation
  • You have had previous abdominal surgeries affecting candidacy for grafting from the abdomen
  • You do not have sufficient skin or tissue along your abdomen
  • You are not undergoing radiation treatments on your chest or upper arm area
  • You are dissatisfied with changes to your breasts

During your consultation, Dr. Lerman can assess your candidacy for SGAP flap reconstruction, or recommend an alternative procedure. To make the determination, he will collect information on your medical history, including recent medical treatments and medication use, and discuss your concerns and cosmetic goals.


After the surgery is performed, patients typically stay in the hospital for three or four days. Surgical drains are usually inserted around your incision sites. When the drainage has decreased, after about one week, you will come into the office for a follow-up visit and the drains will be removed.

Patients will continue to recover for another four to six weeks, returning to work and most daily activities during this time frame. It is advisable to wear loose-fitting clothing during this healing period to avoid irritating your incisions. Patients will need to refrain from strenuous activities for a longer period of time, and until permitted by Dr. Lerman.

Schedule Your Appointment Today

Find out if an SGAP procedure is the best reconstruction approach for your unique situation. Schedule an appointment with Dr. Lerman today by calling (212) 434-6980 or reach out to us online.

Dr. Oren Lerman

Oren Z. Lerman, MD

Dr. Oren Lerman performs a variety of cosmetic and reconstructive procedures with a specialty in reconstructive breast surgery. In fact, he is the director of breast reconstruction at Lenox Hill Hospital's Institute for Comprehensive Breast Care as well as the Microvascular and Cosmetic Breast Fellowship. In addition to the hospital, Dr. Lerman is affiliated with:

  • The New York Regional Society of Plastic Surgeons (Past President)
  • The American Board of Plastic Surgery (Diplomate)
  • The American College of Surgeons (Fellow)
  • The American Society of Plastic Surgeons
  • The American Society of Reconstructive Microsurgery

You can schedule a consultation with Dr. Lerman by filling out our online form or calling (212) 434-6980.

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"The one thing that is most important when we're doing cosmetic surgery and aesthetic surgery of the face or the body is to make sure that the patient is happy afterwards..." Dr. Oren Lerman

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