TUG Flap Reconstruction
(Using thigh tissue)
TUG Flap Reconstruction – (Transverse Upper Gracilis flap)
The tissue and skin is taken from the upper inner thigh area and is used to reconstruct the breast. Part or all of the gracilis muscle is taken along with the tissue from the inner thigh to ensure a reliable blood supply and is connected via blood vessels using microsurgery. The tissue and muscle from the inner thigh in a ‘melon like’ slice makes a cone shape to form a soft and shapely breast. The peak of the cone becomes the nipple. This is a very good option if tissue from the abdominal area is not available either because the patient is very slim or possibly because of too much scarring from previous operations such as appendicitis, caesarean section or abdominoplasty.
Several days before the operation the patient will have an anaesthetic assessment to establish that they are fit for the lengthy procedure. This will take into account the patients medical history and their general health.
- This type of procedure can be used for delayed or immediate reconstruction successfully.
- A TUG flap reconstruction gives good projection and volume for the new breast as it contains muscle from the inner thigh.
- The effect of the gracilis muscle being taken from the inner thigh is unlikely to be noticed by the patient.
- The reconstructed breast will change with the opposite breast – it will alter as you alter in shape and size as it is living tissue.
- This form of reconstruction usually improves over time.
- This is an option for those women who are unable to use tissue from the abdomen either because they do not have enough fat or they have previous scarring.
- One operation, with no further maintenance.
- Nipple reconstruction is done at the time of reconstruction.
- Usually 4 hours of surgery and 4 nights hospital stay.
- The flap is monitored every hour for the first three days
- Generally more suitable for a smaller breasted patients.
FACTS AT A GLANCE
| Surgery time | 4 Hours |
| Hospital stay | 4 Days |
| Anaesthetic assessment | Yes |
| Bladder Catheter | Yes |
| Confined to bed | 1 Day |
| Up and walking | Next day |
| Reasonably mobile | 4th day |
| Full recovery | 6 – 8 weeks |
| Time off work | 4 weeks |
| Bras and garments | Yes |
| Possible reconstruction issues | Tenderness on sitting down |
| Long term issues | Subtle change in thigh contour |
| Secondary surgery | Rarely |
Case 1
IMMEDIATE TUG RIGHT BREAST RECONSTRUCTION with CAMIR MASTECTOMY and NIPPLE RECONSTRUCTION
Case 2
IMMEDIATE TUG BILATERAL BREAST RECONSTRUCTION with CAMIR MASTECTOMY and NIPPLE RECONSTRUCTION and NIPPLE TATTOOING