Restorative Techniques

TUG Flap Breast Reconstruction

Transverse Upper Gracilis and Transverse Upper Thigh Flaps

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The Inner Thigh As A Donor Site

The skin and fat of the upper inner thigh can be used to reconstruct breasts with a natural appearance using warm, supple living tissue. The Transverse Upper Thigh (TUT) and Transverse Upper Gracilis (TUG) flaps may be a good choice for the reconstruction of small and medium-sized breasts, especially when the abdomen is not suitable for use as a donor site. The shape of these flaps facilitates the sculpting of breasts with especially youthful projection and shape. As an added cosmetic benefit, women who choose these flaps have their inner thigh reshaped.

The Surgery

Sometimes an inner thigh flap requires that a small amount of gracilis muscle be incorporated into the flap to assure the adequacy of the flap’s blood supply - such flaps are called TUG flaps. Because a small amount of muscle is included in the harvest of a TUG flap, it is technically not a perforator flap. However, since the gracilis muscle is a very small muscle (unlike the rectus abdominis muscle), and not one of the primary muscles of the leg, it is generally not missed after TUG flap breast reconstruction surgery and there is no risk of developing a hernia at the donor site. Since the amount of muscle removed is so small and functional abnormalities are not associated with its incorporation into a flap, surgeons consider the TUG flap as a perforator flap. Both the TUT and TUG flaps can be harvested so that the donor site scar is placed discretely on the inner aspect of the upper thigh near the groin crease.

As with all free flaps used in breast reconstruction, the blood vessels of the inner thigh flap will be connected to blood vessels at the mastectomy site with the aid of an operating room microscope using microsurgical techniques. The flap is then sculpted and shaped into a new breast.

Optimizing Aesthetics

Approximately three months after the initial stage of breast reconstruction surgery, reconstruction of your nipples (when mastectomy includes their removal), refinement of breast shape and procedures to produce symmetry with your untreated breast can be completed. These optional additional procedures are performed on an outpatient basis and are referred to as Stage II.

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TUG Flap Surgery in New York and Connecticut

Contact us if you would like more information about TUG flap breast reconstruction or for information about other options for breast reconstruction including DIEP flap surgery after mastectomy. Our practice has offices in New York City and Fairfield County, Connecticut.