Types of Reconstruction Surgery The TUG Flap

Photo courtesy of freedigitalphotos.net and Apple’s Eyes Studio

Deciding upon which type of reconstruction surgery to have after losing part of your breast, or all of it, or both of them, to breast cancer is often very difficult, so I decided to devote all of my blog posts this week to a discussion of the various types of reconstruction surgery that are available, together with a little feedback from women who have undergone each type of surgery.

The TUG Flap

The TUG flap is a relatively recent type of reconstruction surgery, it certainly wasn’t available 8 years ago when I went through breast cancer.  It is recommended for women who, due to a slender body type, or due to previous abdominal surgery, can’t have the more utilized TRAM or DIEP flap procedures.

In the TUG flap procedure, your surgeon will utilize fatty tissue, muscle and blood vessels from the inner thigh to reconstruct your breast. TUG is an acronym for “transverse upper gracilis”.

The gracilis is a muscle on the inside of your upper thigh.  It’s a relatively small muscle responsible for helping to move your leg closer to the center of your body.  It is reasonably expendable and does not create any noticeable loss of strength, because other muscles exist which can compensate for its function. The skin and fat carried by the inner thigh flap can be a transversely oriented ellipse just below the groin and buttock crease, which allows the donor site to be closed similar to a thigh lift, resulting in a well concealed scar. Alternatively the incision can be extended vertically along the inner thigh to capture more tissue volume in a sort of fleur-de-lis design, and this allows larger breasts to be reconstructed with the inner thigh flap.

The TUG flap can be used for reconstructing one or both breasts. The scar runs along the inner upper thigh and is well hidden.  An added benefit might be a leaner inner thigh similar to what you might receive after a thigh lift procedure.

Length of Surgery: for one breast, 2-3 hours, for both breasts, 4-6 hours (this may vary according to your surgical team).

Hospital Stay: 4-7 days (ask your surgeon for more info)

From A Practical Point of View…

After this surgery, it’s normal to have some wound healing issues because of the location of the incisions on the inside of the thighs.  You will most likely need a compression garment for the inside of the thighs.

Most survivors mentioned that they needed to avoid sitting in a chair for any extended time during the first two weeks post-surgery, but that laying in bed, sitting in a reclining chair, or walking did not cause problems.  Most complaints were just about the 4 drains they needed to carry around with them after surgery.  That part was a little irritating, but most everyone seemed pretty pleased with this type of reconstruction.

This is microsurgery, a highly specialized field, so please ensure that your surgeon has the requisite experience and skills.

My suggestion?  Make sure you discuss your options thoroughly with your surgeon so that you know all of the pros and cons each type of reconstruction surgery will entail and choose the one that makes sense for you and your lifestyle.

If you choose to have reconstructive surgery, please read my article Tips For Surgery – Useful Items to Take With You.  Another article that might be helpful: My Top Favorite Things to Promote Breast Surgery Recovery.



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