TUG Flap Breast Reconstruction in Austin, TX

A transverse upper gracilis or TUG flap is an advanced breast reconstruction technique, like the DIEP flap, in which Dr. Fisher uses your own excess tissue, not an implant, to create your new breast. The advantages are a natural looking and feeling breast made of healthy, soft, living tissue that, unlike an implant, won’t ever need to be replaced.

In this procedure, Dr. Fisher removes a flap of skin, fat, and underlying gracilis muscle from your upper inner thigh. The loss of this muscle will not adversely affect the function of your leg. Although there are a few patients whose anatomy can sustain a TUG flap without removing the muscle, it is rare and not something that can be determined preoperatively.

TUG Flap Christine Fisher Austin TX

(A) Tissue from the upper part of the inner thigh can be used for natural-tissue breast reconstruction. Although technically this is not a perforator flap, the TUG flap is considered by many to be similar to a perforator flap in that only a very small piece of muscle is removed from the inner thigh, an area of the body with a very large muscle mass, and its removal does not cause any weakness or functional impairment. The scar that results following a TUG flap procedure lies just below the groin crease. (B) The crescent-shaped TUG flap is shaped by bringing the ends of the flap together to shape a breast with youthful contours and projection. The flap is transferred to the chest and the flap’s blood vessels are connected to blood vessels at the recipient site using microsurgical techniques. The location of the surgical scar on the breast will depend on the technique used for the mastectomy itself. Many women choose to have nipple reconstruction and tattooing of the nipple and areola (not shown) in order to have a reconstructed breast that looks as realistic as possible.

Because a TUG flap can result in a higher incidence of lymphedema in the leg, it is only used in cases where patients do not have other donor sites, either due to a thin physique or abdominal scarring from previous procedures such as a tummy tuck. All of your options will be discussed with you in detail during your initial consultation.

Once Dr. Fisher has removed the flap from your upper thigh, she will then transfer it to your chest and connect its blood vessels to ones either in your chest wall or under your arm. It is this part of the procedure in particular, severing the very small blood vessels and reconnecting them using a microscope, that requires advanced technical skills, experience, and microsurgery training.

With the TUG flap breast reconstruction technique, unlike a DIEP flap or a SIEA flap, nipple reconstruction can take place immediately, often without having to tattoo the nipple. The end result is a breast that looks, feels and acts like a natural extension of your body — because it is.

To find out more about a TUG flap, or any other breast reconstruction option, send us a message or call our office at (512) 815-0123 to schedule a consultation.

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