If you are looking for an alternative to breast implants and do not have enough fat on your abdomen for a DIEP flap reconstruction, you may consider the transverse upper gracilis (TUG) flap. At Snyder Plastic Surgery at The Breast and Body Center, we want you to feel like you have options because you do. The TUG flap uses fat from the inner thigh along with the underlying gracilis muscle to provide a well-vascularized and shapely reconstruction. Austin, TX board-certified Plastic and Reconstructive Surgeon Dr. Ned Snyder IV can discuss in detail the tissue reconstruction options available to you based on your body, medical history, and previous surgical history.
The TUG flap technique gives you the added benefits of slimming your inner thighs and recreating the look of your breasts with your own tissue after a mastectomy. When you are not a great candidate for a breast reconstruction from your tummy fat, the TUG flap is a standout choice. In addition, very thin or athletic patients may not have enough abdominal subcutaneous fat to be a candidate for SIEA or DIEP breast reconstruction. Although the TUG flap is not performed widely in the United States, we believe at Snyder Plastic Surgery at The Breast and Body Center that this reconstruction is an excellent choice for many patients and has provided some of the greatest aesthetic results we have seen. The unique shape of the tissue removed from the inner thigh allows shaping of a breast with an almost ideal contour and projection.
"I had an amazing experience with beautiful results - I couldn’t be happier with my breast augmentation results. Everyone that I met from my first consultation to my post follow up after surgery were extremely helpful and informative. Dr. Snyder himself is an amazing surgeon. My results are perfect and better than I ever could have imagined. I highly recommend him if you are thinking about this procedure. His PA, Jen was extremely helpful and informative as well. The facilities from Dr. Snyder’s office to the surgical site used were clean, beautiful and comfortable. I felt well taken care the entire time and am thrilled with my results."- Anonymous / Vitals / Mar 08, 2018
"After back to back pregnancies, my body had been put through the ringer in a short period of time. I had an umbilical hernia and diastasis recti. Dr. Snyder restored my body and sanity after a mini tummy tuck and a much needed breast lift. I never imagined the results I got. They were better than I expected and my husband was very impressed as well. Dr. Snyder is a true artist! I have told all my Mommy friends to get their "Body by Snyder." Thank you Dr. Snyder for making me feel and look like myself again!"- A.D. / Google / Jun 11, 2020
"Highly Recommended - I recently had Eurothreads, non-surgical face lift, with Dr. Ned Snyder and Jen. During the treatment, I was very confident in Dr. Snyder’s expertise and gentleness. Jen was there to assist during treatment and helped explain the procedure to me. I am very pleased with my results. I can not say enough about Dr. Snyder, Jen and his wonderful team. I highly recommend him for non surgical and surgical procedures."- J. / RealSelf / Jan 20, 2020
"I chose Dr. Snyder for my tummy tuck and liposuction. He came highly referred by a friend as well as online reviews. I’m truly thankful that I chose Dr. Snyder and his staff as they cared for me as if I were a loved one. I felt safe, educated, respected, and cared for in a real genuine and honest way.I had first consulted with Sono Bello and fear what my results would have been if I would have chosen that route. I am 5 weeks post surgery, couldn't be happier with my results, my follow ups, and the support from his staff to answer and and all questions along the way. I highly recommend seeing Dr. Snyder and getting to know his care team during your consultation. I've been waiting to do this for a decade and wouldn't change a thing.Thanks team!!!"- M.J. / Google / Oct 21, 2019
"I met Dr. Ned Snyder as I was looking for a second opinion for a revision of breast reconstruction and a neck lift. And I am so happy I did. The interaction between physician and patient started wonderfully since the very beginning. I was able to get an appointment with him soon after my telephone call to his office, and continued smoothly throughout the whole process, prior to surgery, during surgery itself, and on all my post-surgery appointments. Dr. Ned Snyder is not onl...y a fantastic surgeon but also an artist. What he did with my body I consider it a piece of art! The results were well beyond my expectations. Dr. Snyder and all his staff are professional, warm, and courteous. In addition, the cost estimate I received from Dr. Snyder’s office after my consultation with him was about half of previous estimates with other plastic surgeons. I am forever grateful to Dr. Ned Snyder."- C.C. / Facebook / Oct 14, 2019
TUG flaps are the second most common tissue flap by Dr. Snyder at Snyder Plastic Surgery at The Breast and Body Center. We ask that our patients check in as a patient for this procedure to be closely monitored for several days after the operation. General anesthetic will be used. Your general surgeon may be present at the same time if you are having your mastectomy and reconstructive surgeries at the same time. Dr. Snyder will begin your reconstruction with the removal of the fatty tissues and skin of your inner thigh to relocate to the breast mound. The inner thighs can be used to reconstruct small and medium breasts. Skin from the inner thigh and the underlying gracilis muscle are fashioned to construct a vascular and shapely breast. Unlike loss of the rectus muscle, loss of the gracilis muscle does not result in cause a significant increase in hernias or functional loss in the legs.
You will need 6 weeks or more to recover from TUG flap surgery. Taking care of your body and healing should be your main goal once discharged from the hospital. You will need to have a loved one, a family member, or a home nurse to help you for the first couple of weeks. This person will need to be able to help you with hygiene, medication management, emptying your drains, and changing your surgical bandages (just to name a few tasks you will need assistance with in recovery). It may be a challenge to stand up or sit a certain way for several weeks, which is frustrating yet normal. You can expect your body to be swollen, bruised, and sore for a few weeks. Each day you should see improvements in your health, mood, and incision sites. If you suspect that you have an infection in your surgical wounds, or are running a fever, please call Dr. Snyder's office immediately. It is also very important to keep all of your follow up appointments as scheduled. We will also be monitoring and documenting your progress.
Plan Your Procedure
- Recovery Time
- 4 – 6 Weeks
- Average Procedure Time
- 4 – 6 Hours
- Post-op Follow-up
- 7 Days
- Procedure Recovery Location
TUG Flap FAQs
Should I wait to Reconstruct?
You can have a breast reconstruction concurrently with your mastectomy, or you can have a delayed reconstruction at a later date. The decision as to "when" to have your surgery really depends on you and your health. During your consultation with Dr. Snyder, we will guide your treatment plan, but you will have options in your breast restoration process. We know that having a mastectomy, years ago or in the near future, can feel like an overwhelming task. The decision to have a major breast reconstruction can seem very daunting. It is our job to help restore your breast after mastectomy or lumpectomy when it is the right time for you.
Why the thigh?
Usually, women who have an autologous tissue flap reconstruction, the first place to harvest the fat is in the abdomen. However, if there are reasons why the abdomen is not a suitable donor site, Dr. Snyder will look for other places or multiple sites to collect the tissue needed.
What If It Is Only One BReast?
Your nonmastectomy breast can be made to match your reconstructed breast. Your breast may need to be enlarged, reduced, or lifted to be symmetrical with the recreated tissue on the other side. We will discuss this with you at the consultation after a physical examination.