TUG Flap Procedure
Breast reconstruction is a deeply personal experience, as it is linked closely and inextricably with your identity as a woman. That road to recovery–whether to the new you or the old one–is a unique one for every patient. That fact is reflected in a broad array of breast reconstruction options available to those women who elect to pursue them after a mastectomy or other breast trauma. The plastic surgeons at East Coast Advanced Plastic Surgery are well versed in a wide variety of these procedures, including the Transverse Upper Gracilis (TUG) flap procedure.
What Happens During a TUG Flap Procedure?
As with many other flap procedures designed for breast reconstruction surgery, the TUG flap uses donor material from a specific area of the body. In this case, the donor muscle comes from the inner thigh—it’s a small muscle, used in normal function to help close the legs inward. It’s important to note that most patients do not experience any loss of strength in the legs, despite the removal of this muscle, which is one reason why TUG flap procedures are appealing for some women. However, because the donor muscle is a relatively small muscle, TUG flaps are only able to provide a modest amount of volume to the reconstructed breast.
To procure the donor material, surgeons make an incision along the upper inner thigh—which patients are usually able to hide quite easily under a bikini, for example. If you are having both breasts reconstructed, your surgeon will need donor material from both thighs. As a result, there may be some slight resulting asymmetry of the thighs after the surgery, but this is largely dependent on the size of your muscle and, in most cases, is not easily noticeable. The donor material is then implanted into the breast and surgeons will use microsurgery techniques to ensure all blood vessels are adequately connected. Your surgeon will also work to ensure that both breasts are satisfactorily symmetrical, though in some rare cases this may require extra surgery.
Am I a Good Candidate for a TUG Flap Procedure?
As only one of many breast reconstruction procedures New Jersey based East Coast Advanced Plastic Surgery performs, it is important for you to choose the right technique. If you meet most of the following criteria, a TUG flap procedure may be the best option for you:
- You are in generally good physical condition and can withstand the stresses of major surgery
- You have undergone or are planning to undergo a mastectomy
- Your breasts have been damaged or are missing due to lumpectomy, radiation, injury, or birth defect
- Your breast abnormality or trauma causes you to feel less feminine or simply makes you unhappy or unsatisfied
- Your desired breast size is more modest or you are open to augmenting your TUG flap with an artificial implant to reach your desired size
- You are not eligible for or have a history of complicated breast reconstruction procedures that involve abdominal tissue, such as DIEP flap procedures.
- Your abdominal tissue is a problematic area to find donor tissue
- You want to achieve a natural look and feel with your reconstructed breasts
During your initial consultation with the plastic surgeons at East Coast Advanced Plastic Surgery, we will discuss your desired goals and how we might reach them together. While the reconstructed breast can never match the exact look and feel of your natural breasts, our goal is achieve the best possible realistic outcome. To help us do that, you should be prepared to discuss your full medical history, not only tobacco or alcohol use, but also medical treatment, previous surgeries, drug allergies, current medications and more. The more information we discuss, the more assured we can be in meeting the desired final results.
Special Considerations for a TUG Flap Procedure
Because breast reconstruction is such a personal endeavor, it’s important to remember that every patient is different. However, there are some special considerations you may wish to keep in mind.
Age: Breast reconstruction for breast cancer patients may be performed at any age, but it is best if the breast has fully stopped developing.
Cancer Treatment: Ongoing cancer treatments can affect the optimal timing of certain procedures, and can dictate which procedures are performed at which time. It is important to discuss with your plastic surgeon how your cancer treatment will affect your reconstruction. At times, multiple procedures may be necessary for optimal reconstruction outcomes.
Pregnancy: It is important to inform your ECAPS surgeon if you are considering having children in the future. Pregnancy can cause bodily changes, which can affect the long-term results of your surgery. Your ECAPS surgeon may have special instructions on how to care for your results.
Surgery and Recovery
Because in some ways, a TUG Flap procedure is almost like two surgeries in one, it is always performed in a hospital setting, and may require a hospital stay of several days (sometimes up to four). You will not be discharged until your surgeon is confident that you can walk with minimal assistance and that you will be able to perform most of your daily at-home routines (brushing your teeth, for example). There will be scars after surgery, but most of those scars will be easily hidden by clothing.
After surgery, you will need to wait anywhere between four and six weeks before resuming your normal activities, but the overall soreness should start to subside after a week or two. This is also when any surgical drains—assuming healing has gone according to schedule—may be removed. You will also need to follow up with your surgeon to discuss nipple reconstruction, if desired, and general follow up care. The plastic surgeons at East Coast Advanced Plastic Surgery will provide you with personalized after-surgery care instruction to safeguard you results and your comfort during your recovery period.