title: Bilateral simultaneous breast reconstruction with SGAP flaps.
abstract: BACKGROUND
  Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral breast reconstruction; 2) to analyze our experience with lateral septocutaneous superior gluteal artery perforator flaps for that procedure; 3) to compare our results with those in the literature; and 4) to highlight the importance of preoperative three-dimensional computed tomographic angiography.
  
  
  METHODS
  A retrospective chart review was completed for 23 patients who underwent breast reconstruction between December 2005 and January 2010 via an SGAP flap (46 flaps). We reviewed flap weight, ischemia time, length of stay, overall flap survival, fat necrosis development, and emergency re-exploration.
  
  
  RESULTS
  Mean weights were 571.2 ± 222.0 g (range 186-1,117 g) and 568.0 ± 237.5 g (range 209-1,115 g) for the left and right buttock flap, respectively. Mean ischemia time was 129.1 ± 15.7 and 177.7 ± 24.7 minutes for the first and second flap, respectively. Mean hospital stay was 5.3 ± 2.5 days. All flaps survived. Fat necrosis developed in five flaps (10.8%), and emergency re-exploration was required in three patients (three flaps).
  
  
  CONCLUSIONS
  When harvesting abdominal tissue is a poor option, the SGAP flap is an efficacious procedure for patients desiring autologous breast reconstruction, and bilateral procedures can be performed simultaneously.
authors.affiliation: Department of Plastic Surgery, The Johns Hopkins University, Baltimore, MD 21287, USA.
authors.forename: Jaime I
authors.initials: JI
authors.lastname: Flores
authors.forename: Michael
authors.initials: M
authors.lastname: Magarakis
authors.forename: Raghunandan
authors.initials: R
authors.lastname: Venkat
authors.forename: Sachin M
authors.initials: SM
authors.lastname: Shridharani
authors.forename: Gedge D
authors.initials: GD
authors.lastname: Rosson
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery; D002081:Buttocks / Q000098:blood supply / Q000000981:diagnostic imaging; D005260:Female; D006085:Graft Survival; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed