Inner Thigh Flap Reconstruction (TUG Flap) _ Orange County | Newport Beach
What is a TUG Flap?
For patients who are able to benefit from reconstruction using their own tissues, the skin and fat from the abdomen remains the most commonly used tissue to create what is known as a breast mound (DIEP flap or TRAM flap). However, when that option is not favorable because of a thin body type, or as a result of previous abdominal surgery, another option known as a transverse upper gracillis free flap (TUG flap) or inner thigh flap can be a viable option.
The TUG flap uses fatty tissue that exist in the inner thigh for the purpose of reconstructing the breast. The gracillis muscle is a small adductor muscle that can be removed without any noticeable loss of strength, because other adductor muscles compensate for any one abductors loss. The skin and fat located on the inner thigh flap is then… Skin located just below the groin and buttock crease. This allows the donor site to be closed in a similar method to a thigh lift which results in a very well concealed scar. In some cases the incision can be extended vertically along the inner thigh in order to gain more tissue volume. This is similar to a fleur-de-lis design. This method is ideal for creating larger breast.
The TUG flap can be harvested from either one side of the thigh or both sides of the thigh for both unilateral and bilateral reconstruction, respectively. Dr. Seify can elevate flap at the same time a mastectomy is performed. The TUG flap is then transferred to the chest and its blood vessels are connected utilizing the operating microscope. The advantages to the inner thigh flap reconstruction consist of the softness and pliability of the tissue that comes from the inner thigh which allows for superior shaping and a natural appearing breast reconstruction with excellent protection. The resulting scar that runs along the inner thigh is well hidden and in many cases creates a leaner contour of the inner thigh similar to the contour following a thigh lift procedure. Additionally, when compared with reconstruction utilizing tissue from buttocks (GAP flap) setting up the operation is much more efficient which allows for a more reliable elevation of the flap. However, the procedure is very dependent upon the patient’s body type, the volume of tissue that can be transferred from the thigh, and appropriate patient selection.
Ideal candidates for Inner Thigh Flap Breast Reconstruction Augmentation (TUG flap) include but are not limited to:
- Patients who have an athletic body with small amount of abdominal fat,
- Patients who have had certain abdominal surgery (e.g., tummy tuck, ventral hernia repair), that make abdominal flaps impossible,
- Patients who have some excess fatty tissue along the upper inner thigh (thighs touching each other),
- Patients who require medium or small volume for breast reconstruction,
- Patients who desire a more naturally shaped and softer feeling reconstructed breast over implant reconstruction.
Patients who are not ideal candidates for TUG flap reconstruction include:
- Patients who haveexcess abdominal tissue favoring a DIEP flap harvest,
- Patients who have tight and skinny thighs,
- Patients who require large volume for an adequate size breast reconstruction,
- Patients who are opposed to having a thigh-lift scar.
Postoperative care following the inner thigh flap procedure includes a compression garment for the thighs. Minor wound healing issues are common and could require dressing changes; however, the final scar is usually very favorable. Sitting in a chair for extended periods of time should be avoided during the initial two weeks following surgery, laying in bed, using a reclining chair, then walking are encouraged to a wound healing. Dr. Seify provide each patient with detailed written and oral instructions following surgery.