Q: I am thin and I already had a tummy tuck seven years ago. I was diagnosed with stage 3 breast cancer in January, and I’ve had my bilateral mastectomy and wanted to know the different options of reconstruction. I’ll be going through radiation treatments in a week, and it should end in 5 weeks. I’ll be interested in reconstruction after my recovery from radiation.

A: Thank you for your question. I’m sorry you are having to contemplate breast reconstruction options. We understand that you have a lot to consider and make it our mission to help you get answers to your questions. As you know, natural tissue reconstruction using your fatty tissue is the recommended option for breast reconstruction following radiation. The most common option for a donor site is the lower tummy fatty tissue. Since you have had a tummy tuck, you will need to consider another option, and the sGAP is a very good option for many women in your circumstance. Since 2002, the GAP flap has been our second most often used procedure for breast reconstruction, often used when the DIEP flap is not an option. You may also be aware

that the number of surgeons who have been trained to do the GAP are few and those with experience doing the procedure regularly for 18 years is even fewer, so I’m glad you contacted me.

I hope you have recovered well from your surgery and that your radiation treatments go well. Our usual approach is to perform the GAP flap after our patients have recovered from their radiation. We usually wait approximately three months after the last radiation treatment to proceed, depending on the circumstance. If you would like to see me in a consult to discuss your options, just let me know. We can consult in person or virtual depending on where you live and what is most convenient.

Thank you again for your question.

Dr. James Craigie