Other tissue reconstruction options are available to patients that have had previous abdominoplasty (tummy tuck surgery) or surgical procedures that preclude the use of abdominal tissue for breast reconstruction.  In addition, very thin or athletic patients may not have enough abdominal subcutaneous fat to be a candidate for SIEA or DIEP breast reconstruction.  In many of these patients, the TUG flap can be used to reconstruct small and medium breasts.  Skin from the inner thigh along with the underlying gracilis muscle is used to provide a well vascularized and shapely reconstruction.  Unlike loss of the the rectus muscle, loss of the gracilis muscle does not result in any significant increase in hernias or functional loss in the legs. Although the TUG flap is not performed widely in the United States, we believe this reconstruction is an excellent choice for many patients and provides some of the best 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. And, this flap uniquely provides the potential for immediate nipple areola reconstruction, without tattooing.

The skin that is removed from the inner thigh is outlined in the illustrations below in blue.  The design maximizes skin and fat use and allows greater potential for flap sculpting than in the DIEP and SIEA reconstructions. The scar is made high iin the inner thigh. The design is similar to the cosmetic inner thigh lift.

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