Donor-site morbidity of the inferior gluteal artery perforator flap for breast reconstruction in teenagers

Correction of severe breast asymmetry in teenage girls presents many challenges. The reconstructed breast should provide symmetry in size, texture and shape that can change naturally with body weight variations and aging. To meet these goals, autologous reconstruction is an excellent option in patients with severe asymmetry. Given that the body constitution of teenagers is often not abundant in adipose tissue, the buttock area becomes an interesting possibility because of its consistent availability of fatty tissue. Since 1996, our team has used the buttock area as the donor site for breast reconstruction in teenagers: the inferior gluteal musculocutaneous flap until 2005 and, since then, the inferior gluteal artery perforator (IGAP) flap. The donor-site morbidity of the musculocutaneous flap was reviewed by our team in 2007 (1): the principal morbidities were posterior thigh hypoesthesia and lateral thigh depression. Some studies on the IGAP flap have included a donor-site morbidity outcome, but it has always been qualitative or subjective in nature (2–12). The expectation of a ‘perfect’ result in this teenage population is common; therefore, it is very important that patients have a clear understanding of the surgery’s limitations, particularly regarding donor-site morbidity. The aim of our study was to objectively assess the impact on donor-site morbidity of preserving the gluteus maximus muscle and of minimizing the area of dissection with the use of the perforator variant of tissue harvesting, the IGAP flap.