Categories of Flap Surgery
There are two main types of flap surgery:
Free Flap Surgery – The tissue is completely detached from its original location and transferred to the breast.
Pedicled Flap Surgery – The tissue remains attached to its original blood supply and is rotated to the breast area.
Free flap surgery is more advanced and requires microsurgery to reconnect the blood vessels, while pedicled flap surgery is simpler but may involve muscle loss.
Abdominal-Based Flap Surgeries
These flaps use skin and fat from the lower abdomen, often providing a tummy tuck effect as a bonus.
DIEP Flap (Deep Inferior Epigastric Perforator Flap)
Most common and advanced flap technique Uses skin & fat from the lower abdomen but preserves the muscle Tummy tuck effect – Tightens the abdomen while reconstructing the breast Requires microsurgery to reconnect blood vessels
Considered the best option for natural and long-lasting breast reconstruction.
SIEA Flap (Superficial Inferior Epigastric Artery Flap)
Similar to DIEP, but uses a different set of blood vessels Less invasive than DIEP since it does not cut deep into the abdominal wall Not suitable for all women – Only those with strong superficial blood vessels
Less commonly performed but offers the same tummy tuck benefits as DIEP.
TRAM Flap (Transverse Rectus Abdominis Muscle Flap)
Uses skin, fat, and part of the rectus muscle from the lower abdomen Can be pedicled (remains attached) or free (requires microsurgery) More invasive than DIEP, since it removes part of the abdominal muscle Higher risk of abdominal weakness and hernias
Best for women who do not qualify for DIEP but have enough lower abdominal tissue.
Gluteal-Based Flap Surgeries (Buttock Tissue)
For women who do not have enough abdominal fat, the buttocks can be used as a donor site.
SGAP Flap (Superior Gluteal Artery Perforator Flap)
Uses skin & fat from the upper buttocks No muscle is taken, preserving strength and function More complex microsurgery, requiring an expert surgeon
Best for thin women who don’t have enough abdominal tissue.
IGAP Flap (Inferior Gluteal Artery Perforator Flap)
Similar to SGAP, but takes tissue from the lower buttocks More discreet scar placement compared to SGAP Longer, more complex surgery
Alternative for women who prefer tissue from the lower buttocks instead of the upper.
Thigh-Based Flap Surgeries
For women who don’t have enough fat in the abdomen or buttocks, thigh-based flaps are a great option.
TUG Flap (Transverse Upper Gracilis Flap)
Uses skin, fat, and a small portion of the gracilis muscle from the inner thigh Results in a natural breast shape Thigh lift effect – Slims the inner thighs while reconstructing the breast
Best for women who want moderate breast size reconstruction and thinner thighs.
PAP Flap (Profunda Artery Perforator Flap)
Uses skin & fat from the back of the upper thigh No muscle loss, preserving leg strength Better for creating a natural breast shape than TUG
Best for women who don’t want any muscle removal and have enough thigh fat.
Back-Based Flap Surgery
For women who cannot use tissue from the abdomen, buttocks, or thighs, the upper back can be used.
Latissimus Dorsi Flap
Uses skin, fat, and muscle from the upper back Can be combined with an implant for more volume Leaves a scar on the back, but it’s well-hidden Some women experience minor back weakness Good for women who don’t have enough abdominal or thigh fat.
Comparison of Flap Surgery Techniques
Procedure | Tissue Source | Uses Muscle? | Microsurgery Required? | Best For |
DIEP Flap | Lower abdomen |  No |  Yes | Women wanting a tummy tuck effect with no muscle loss |
SIEA Flap | Lower abdomen | No | Yes | Women with good superficial blood vessels |
TRAM Flap | Lower abdomen | Yes | Yes (if free flap) or No (if pedicled) | Women who don’t qualify for DIEP |
SGAP Flap | Upper buttocks | No | Yes | Thin women without abdominal tissue |
IGAP Flap | Lower buttocks | No | Yes | Women preferring a lower buttock donor site |
TUG Flap | Inner thighs | Yes | Yes | Women wanting a thigh lift effect |
PAP Flap | Upper back of thigh | No | Yes | Women preferring no muscle loss |
Latissimus Dorsi Flap | Upper back | Yes | No (usually) | Women lacking abdominal or thigh fat |
Choosing the right method depends on your body type, health, and goals!
Who Performs Flap Surgery for Breast Reconstruction?
Flap surgeries require a highly skilled:
Plastic & Reconstructive Surgeon – Specializing in breast reconstruction Microsurgeon – Reconnects tiny blood vessels for free flap procedures Breast Cancer Reconstruction Specialist – Experienced with mastectomy patients Only highly trained specialists perform advanced microsurgical techniques like DIEP, SGAP, and TUG flaps.
How Much Does Flap Surgery Cost in Turkey?
Turkey offers world-class flap breast reconstruction at a fraction of the cost compared to the USA and UK.
Procedure | Cost in Turkey (€/$) | Cost in USA ($) | Cost in UK (£) |
DIEP Flap | €7,000 – €12,000 ($7,500 – $13,000) | $25,000 – $50,000 | £18,000 – £30,000 |
SGAP/IGAP Flap | €8,000 – €14,000 ($8,500 – $15,000) | $30,000 – $60,000 | £22,000 – £35,000 |
TRAM Flap | €6,000 – €10,000 ($6,500 – $11,000) | $15,000 – $35,000 | £12,000 – £25,000 |
Turkey offers expert microsurgery at affordable prices!
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