Gluteal free flap is a less common type of breast reconstruction surgery. The surgeon cuts a flap of muscle, fat, and skin from the buttocks and moves it to the chest to create a new breast. The blood vessels are also cut. After the flap is in place, the surgeon sews the blood vessels in the flap to blood vessels in the chest area. This requires careful surgery using a microscope.

Gluteal free flap may be a good choice for thin women who don't have enough belly tissue for DIEP or TRAM flap surgery. But the buttocks may be uneven after surgery.