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
"Dr. Snyder, his P.A. Jen, Laurene, and the entire staff have been the most outstanding and accommodating medical professionals with whom I have ever interacted. They go above and beyond in virtually every way I can imagine. The facilities are updated and pristine. They are kind and genuinely care for their patients. I have had two major surgeries after almost 200 pounds of weight loss and, while the recovery after those procedures was always going to be long and difficult, Dr. Snyder and his staff has made all the work more than worth it. I would give more than 5 stars if I could. -Justin"- J.T. / Yelp / Jul 05, 2019
"Dr. Snyder and his PA, Jenn, were excellent. I was consistently treated with compassion and dignity. RNs and office staff were also excellent! I had a double mastectomy with DIEP flap reconstruction. The results were amazing, and included 3D nipple tattoos."- Anonymous / Healthgrades / Jul 03, 2019
"Amazing results. Great doctor. Could not have asked for more. Removed old implants and lifted breasts. So remarkable. Ned Snyder the one to go to."- J.B. / Yelp / May 02, 2019
"Ready to fix my arms! Scheduled May 22 - I have friends ballyhoos made the play now and decided to do so something about my arms. Lost 115 lbs 13 year ago and had tummy tuck and breast lift 10 years ago. READY to fix my arms! Scheduled may 22"- N. / RealSelf / Apr 27, 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.