PAP Flap or TUG Flap

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Natural-Looking Reconstruction Results in Austin, TX

A profunda artery perforator (PAP) flap or transverse upper gracilis (TUG) flap at Austin's Christine Fisher MD is like the DIEP flap in that no implant is required since Dr. Fisher uses tissue taken from a donor site to achieve breast reconstruction. A PAP flap is a thigh lift flap that takes no muscle and has a well-hidden scar in a different location. While implants ultimately need to be replaced, your own healthy, living tissue used to create a new breast does not.


Discover whether a PAP or TUG flap from Austin Plastic & Reconstructive Surgery is right for you. Call Austin Plastic & Reconstructive Surgery at (512) 815-0123 or send a message online to arrange a consultation.

In a PAP flap, Dr. Fisher removes a flap of skin, fat, and no muscle from your posterior and inner thigh. In a TUG flap, Dr. Fisher removes a flap of skin, fat, and underlying gracilis muscle from your posterior and 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 flap without removing the muscle, this is rare and not something that can be determined preoperatively.

PAP Flap Breast Reconstruction

Download Our Breast Reconstruction Post-Operative Care Guides

We've compiled detailed post-operative care instructions to best equip our breast reconstruction patients throughout their recovery process. To ensure the best and safest recovery, your plan encompasses appropriate prescriptions and clear directions towards maintaining your comfort to get you back to normal life and activity as soon as possible. Individual patients respond uniquely, and the type of procedure may differ, but these basic guidelines will help you along your journey.

Download Post-Operative Care Guides

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.

Austin Plastic & Reconstructive Surgery

  • Known for natural-looking aesthetic results in breast reconstruction and cosmetic surgery.
  • Elected by peers for inclusion in Texas Monthly's Texas Super Doctors®: Rising Stars listing.
  • Reconstructed over 3,000 patients, including more than 1,500 DIEP flap reconstructions.
  • 4.9-star average rating over hundreds of reviews for cosmetic surgery.
  • American Society for Aesthetic Plastic Surgery (ASAPS)
  • American Society of Plastic Surgeons (ASPS)
  • American Society for Reconstructive Microsurgery

A PAP flap is a crescent of fat and skin that is removed from the posterior thigh with its main feeding blood vessel, and can be used to create a living-tissue breast. This flap is sometimes described as the "banana roll" of fat, as it uses the fat roll below the gluteus creases to make a breast. No muscle is removed. The scar is a line along the bottom of the gluteal (buttocks) fold and is well hidden.


Choose a Plastic Surgeon With a Personal Touch

Dr. Fisher values patient education, which is why she uses her website to explain the reconstructive procedures she offers, such as PAP flap surgery. But her commitment to sharing information does not stop there. She also believes in using an initial consultation and ongoing conversations to equip every woman who comes to Christine Fisher MD with specific and thorough knowledge about the procedure they choose together.

Once Dr. Fisher has removed the flap from your upper thigh, she will then draw on her advanced technical skills, extensive experience, and microsurgery training to transfer it to your chest and connect it to blood vessels in your chest wall or the underarm area. This is delicate and intricate work that involves the use of a microscope. Finally, she will artistically shape the breast to create an aesthetically pleasing result.

As with all surgeries at Austin Plastic & Reconstructive SurgeryD, the goal of a TUG flap or PAP flap surgery is to provide you with a breast that looks and feels natural—a definite benefit of using your own tissue.


Discuss the TUG flap or PAP flap with Austin Plastic & Reconstructive Surgery in Austin, TX. Set up a consultation by calling (512) 815-0123 or sending a message online.

Before and After Photo
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