As an important tissue transfer method in breast reconstruction, the gluteal flap has shown high applicability and good surgical results in clinical applications in recent years. With the increase in breast cancer patients and the improvement of aesthetic requirements for breast reconstruction, the advantages of the gluteal flap have gradually attracted attention. This article will systematically explain the anatomical characteristics, surgical techniques, scope of application, advantages and disadvantages, and postoperative recovery of the gluteal flap, in order to provide a reference for the clinical selection of breast reconstruction.
1. Anatomical basis of buttocks flap
The gluteal flap mainly includes the superior gluteal flap (SGAP) and the inferior gluteal flap (IGAP), both of which are based on the perforating blood vessels of the deep gluteal arterial system. The gluteal area has abundant skin and subcutaneous tissue, moderate flap thickness, stable blood vessel supply, and good elasticity of flap tissue, which is conducive to the shaping of breast shape. The blood supply of the gluteal flap mainly depends on the perforators of the superior gluteal artery and the inferior gluteal artery. These perforators are distributed in the subcutaneous fat tissue of the buttocks and have good blood supply guarantee.
2. Surgical techniques of buttocks flap in breast reconstruction
Buttocks flap breast reconstruction usually uses free flap technology. The surgical steps include flap design, vascular exposure, flap removal, vascular anastomosis and breast shaping. The flap design is personalized according to the patient's buttocks anatomical structure and breast size. When taking the flap, the perforating vessels must be carefully protected to ensure adequate blood supply to the flap. The free flap is microsurgically anastomosed through the chest vascular system to ensure smooth blood flow after surgery. The shaping of the flap shape during the operation needs to take into account both symmetry and naturalness to achieve a satisfactory aesthetic effect.
3. Scope of application of buttocks flap
The gluteal flap is suitable for the following types of breast reconstruction patients:
Those without sufficient abdominal fat or with a history of abdominal surgery : If the abdomen has undergone multiple surgeries or has a lot of scar tissue, the use of abdominal flaps is limited, and buttocks flaps become an alternative.
Those who need a thicker fat layer to reconstruct fuller breasts : The buttocks are rich in fat and can provide sufficient soft tissue volume, which is suitable for the reconstruction of medium to large breasts.
Those who wish to avoid abdominal incision or damage to abdominal wall function : The gluteal flap is taken from the buttocks, avoiding the potential impact on the abdominal wall muscle function.
Those whose physical conditions allow free flap microsurgery : The buttocks flap relies on microvascular anastomosis and is suitable for patients with good vascular conditions and physical fitness.
Advantages of Buttock Flap Breast Reconstruction
The tissue texture is soft and the breast shape is natural : the fat tissue of the buttocks flap has moderate density and uniform thickness, and the reconstructed breast feels more realistic.
The scar is concealed and the aesthetic effect is good : the buttocks incision is concealed, avoiding exposure of the abdominal incision and helping patients regain their self-confidence.
Complete abdominal function after surgery : Unlike abdominal flaps, gluteal flaps do not involve the abdominal wall muscles, avoiding the risk of weakened abdominal muscles or hernia.
The donor site recovers quickly : The buttocks tissue has rich blood supply, and the postoperative wound heals quickly, reducing the risk of infection and necrosis.
5. Limitations and Challenges of Buttock Flap Breast Reconstruction
The operation is complex and requires high technical skills : the buttocks flap harvesting and microvascular anastomosis are technically difficult, the operation time is long, and the surgical team needs to have high experience.
The patient's position adjustment is complex : a special position is required during flap removal, which increases the difficulty of surgical anesthesia and operation.
The donor area may be affected in terms of function and morphology : buttocks flap harvesting may cause local fat depression or uneven morphology, so preoperative evaluation and postoperative repair are necessary.
Vascular anatomy varies greatly : The individual differences of gluteal perforating vessels are large, which increases the difficulty of finding and protecting blood vessels during surgery.
6. Postoperative Recovery and Complication Management
After surgery, patients should maintain adequate rest and avoid excessive compression of the buttocks to protect the blood supply of the flap. Common complications include partial necrosis of the flap, infection, and hematoma. Early detection and timely treatment can significantly reduce adverse consequences. During the recovery period, physical therapy and functional training are used to promote the recovery of the donor and recipient areas and reduce local stiffness and functional disorders. Psychological support is equally important to help patients adjust their emotions and enhance their quality of life after surgery.
VII. Clinical research and future prospects of gluteal flap breast reconstruction
Currently, many clinical studies have shown that gluteal flap breast reconstruction performs well in terms of safety and aesthetic effects. With the continuous development of microsurgical technology, intraoperative vascular exposure and anastomosis techniques have gradually matured, and the success rate of surgery has increased. In the future, three-dimensional imaging and personalized design can be used to optimize flap shape and improve the accuracy and satisfaction of breast reconstruction. In addition, combining tissue engineering technology may achieve more ideal breast tissue regeneration.
Buttock flap breast reconstruction provides a new option for some patients who are not suitable for abdominal flaps, and broadens the surgical options for breast reconstruction. The surgeon needs to formulate a reasonable surgical plan based on the individual conditions of the patient, comprehensively consider the characteristics of the donor and recipient areas, and ensure efficacy and safety.
Beauty Encyclopedia Tips: Buttocks flap is widely used in specific patient groups in breast reconstruction because of its unique anatomical advantages and good postoperative morphological performance. When choosing a suitable reconstruction plan, it is necessary to weigh the complexity of the operation and the needs of the patient, and actively prevent postoperative complications to achieve the best breast reconstruction effect and patient satisfaction.