Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 24:
Superior Gluteal Free Flap for Breast Reconstruction

The inferior skin incision is then made down through the gluteus maximus, carefully preserving the vascular pedicle entering the muscle segment being removed with the skin paddle.

C. The myocutaneous transplant is depicted with its superior gluteal vascular pedicle.

Clinical Cases


A 48-year-old woman had a gluteal free flap reconstruction after a modified radical mastectomy.

FIG. 24-01. Frontal view.

FIG. 24-02. Oblique view.

FIG. 24-03. Frontal view, 1 1/2 years after gluteal free flap reconstruction. Note the biopsy incision of the contralateral (right) breast.

FIG. 24-04. Oblique view.


A 40-year-old woman had a radical mastectomy.

FIG. 24-05. Frontal view.

  FIG. 24-06. Oblique view.

FIG. 24-07. Recipient site preoperative markings. Note the proposed internal mammary recipient vessels, and the position of the proposed skin incision and later nipple position.

FIG. 24-08. Donor site preoperative markings. Note the extension of the skin paddle toward the midline.

FIG. 24-09. Cross-sectional view of the superior gluteal flap. Note the relative thickness of the skin, subcutaneous tissue, and muscle; and the wedge-like conFIGuration of the flap.

FIG. 24-10. Postoperative frontal view.


A 51-year-old woman was seen after an extended radical mastectomy with rib resection. The breast had been reconstructed with a latissimus dorsi pedicle myocutaneous flap and submuscular implant. The patient had a capsular contracture, implant deformation, and displacement.

FIG. 24-11. Preoperative frontal view.

FIG. 24-12. Oblique view.

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