TUG Flap

Jandali Plastic Surgery

The TUG flap is an innovative surgery that is another option for patients who are not candidates for DIEP flap breast reconstruction.

What is TUG Flap Surgery from the Thigh?

“TUG” stands for Transverse Upper Gracilis, which is a muscle in the upper thigh. The surgery is a type of microsurgical breast reconstruction procedure that uses a patient’s own tissue to rebuild the breast after a mastectomy. Unlike traditional reconstruction techniques that rely on implants, a TUG flap uses a patient’s own tissue to create a new breast that looks and feels natural. The procedure is performed using a flap of skin, fat, and muscle from the patient’s inner thigh, which is then shaped and positioned to create a new breast.

Why Choose TUG Flap Surgery?

There are several benefits to choosing TUG flap surgery over other breast reconstruction options. Firstly, the procedure uses the patient’s own tissue, which means that the new breast will look and feel natural. This is because the tissue used in the procedure has a similar texture and consistency to that of the breast tissue. When compared to implant breast reconstruction, a TUG flap has a lower risk of infection. A further benefit is that an inner thigh lift is performed when the tissue is removed and transplanted to the breast for reconstruction.

How is TUG Flap Surgery Performed?

TUG flap surgery is performed under general anesthesia and typically takes 5-6 hours for one breast and 8-9 hours for both breasts. The procedure begins with the removal of a flap of skin, fat, and muscle from the inner thigh. Dr. Jandali and his team will use microsurgical techniques to attach the blood vessels in the flap to those in the chest area. This process is known as anastomosis and is critical to the success of the procedure. This tissue is then shaped and positioned to create a new breast. Drains are placed in the breast and thigh area and all the incisions are closed.

Procedure Outline

The following is a general outline of the steps involved in TUG flap surgery:

Anesthesia: The patient will be under general anesthesia to ensure that they are completely asleep and pain-free during the procedure. The anesthesia team also performs nerve block in the chest area to help with postoperative pain control for 2-3 days.
Harvesting the Flap: Dr. Jandali will make an incision in the upper inner thigh to remove a flap of skin, fat, and the transverse upper gracilis muscle. This flap of tissue will be used to create the new breast.
Reattaching the Blood Supply to the Flap: Dr. Jandali will carefully move the flap of tissue up to the chest area and perform the anastomosis to reestablish the blood flow.
Shaping the New Breast: Dr. Jandali will then reshape the relocated tissue to create a new breast that is proportional and symmetrical with the other breast.
Closure of the Incisions: Drains are placed at each surgical site and the incisions in the inner thigh and chest will be closed with dissolvable sutures.
Recovery: After the procedure, the patient will be taken to a recovery area where they will be closely monitored for any signs of complications. The patient will typically need to stay in the hospital for 2-3 days to allow for proper healing and recovery.

It’s important to note that every patient’s experience with TUG flap surgery is unique, and the exact steps involved in the procedure may vary depending on the patient’s individual needs and goals. At Jandali Plastic Surgery, our experienced team will work closely with each patient to develop a personalized treatment plan that meets their individual needs and expectations.

Recovery After TUG Flap Surgery

The recovery process after TUG Flap surgery will vary depending on the individual patient and the extent of their procedure. Most patients can expect to experience some pain and discomfort for the first few days after surgery, which can be managed with medication. It is also common for patients to experience swelling and bruising in the area where the tissue was harvested, as well as in the chest area.

Patients will need to wear a compression garment on the thighs for several weeks after surgery to help reduce swelling and promote healing. They will also need to avoid strenuous activity and heavy lifting for about 2 months after surgery.

Natural Breast Reconstruction with TUG Flap

The new breast created by a TUG flap will look and feel natural, and can help to restore a patient’s confidence and self-esteem after a mastectomy. It will soften over time and age well with a patient. If a patient loses weight, the flap and breast size will get smaller. If a patient gains weight, the flap and breast size will enlarge.

Frequently Asked Questions

What is TUG Flap Breast Reconstruction?

TUG (Transverse Upper Gracilis) Flap is a type of breast reconstruction that uses tissue from the upper part of the inner thigh (including skin, fat, and muscle) to reconstruct the breast after a mastectomy.

How is TUG Flap different from other flap procedures?

TUG Flap uniquely utilizes tissue from the upper inner thigh. This may result in less visible scarring and can be a good option for women who do not have enough abdominal tissue for other types of flaps.

Who is an ideal candidate for the TUG Flap procedure?

Ideal candidates are women with sufficient tissue in their upper inner thighs and those who prefer a natural tissue reconstruction method. A consultation with your doctor will determine if this is the best procedure for you.

What can I expect during recovery from a TUG Flap procedure?

Recovery typically involves a hospital stay of a few days, followed by several weeks of rest at home. Physical activity should be gradually resumed according to your doctor’s recommendations.

How natural will the results look and feel after a TUG Flap procedure?

Since TUG Flap uses your own body tissue, the reconstructed breast should look and feel more natural than an implant. However, results may vary based on individual circumstances and surgical outcomes.

Contact Our Connecticut Plastic Surgery Office for TUG Flap Breast Reconstruction

At Jandali Plastic Surgery in Trumbull, Connecticut, our team of experienced and knowledgeable providers is dedicated to providing patients with the highest quality of care and the best possible outcomes. If you are interested in learning more about TUG flap surgery or any other flap procedures for breast reconstruction, we encourage you to contact our office to schedule a consultation.

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I recently had a double mastectomy with reconstruction and Dr. Jandali is not only great at what he does, he is an amazing surgeon and perfectionist that is kind and warm with an exceptional staff. Each person I have met in his office is wonderful all across the board his office is a fantastic place that I highly recommend to anyone, you will not be uncomfortable or disappointed. All the girls on his team are truly the BEST he sure knows how to pick his staff, LOVE them!!! I look forward to my visits and am beyond grateful to be in the best care. Thankful to all of you for my experience I can't say enough. :-)

This is a wonderful place. I came to Dr. Jandali’s office after finding out I had breast cancer. It was such a scary time in my life but Dr. Jandali made me feel comfortable and explained my options for reconstruction after mastectomy. I opted for the DIEP flap and am very happy with the results. Dr. Jandali basically performs magic in making things look better. He and his entire staff are so professional and kind. The PAs Jennifer, Brielle, and Shelby are amazing. They spent so much time with me explaining everything along the way and answering any questions I had. Plus, it is obvious that they really care. I am actually going to miss seeing them.

I met Dr. Jandali and his team after making the decision to undergo a double mastectomy with reconstruction. At 32 years old, learning I was BRCA2 positive and having two toddlers at home, I was so scared and didn’t know what to expect. Between Dr. J & Shelby, I was immediately put at ease and walked through the entire process. Shelby, was and is, still my strength when I walk into the office. She has reassured me, talked me through all my emotions, and has been AMAZING on this journey. I can’t thank Shelby enough. And Dr. J and his expertise, made me feel like myself again, it’s like I came out of this better then ever! Thank you all!!

I cannot recommended Dr. Jandali enough for any women who are undergoing DIEP flap reconstructive surgery after mastectomy. Dr. Jandali and his phenomenal staff are so not only knowledgeable and extremely capable but kind and sensitive to the situation that their patients are going through. They take their time to explain every step of the surgery, even taking the time to draw pictures and answer any questions I had. I was very well informed about what would take place and my expectations were well exceeded. Being diagnosed with breast cancer was a challenge but I cannot express my gratitude that I had Dr. Jandali and his team on my side.

I walked into Dr. Jandali’s office for a consultation with so much sadness and fear of what lie ahead for me. I had previously met with a few other plastic surgeons but knew after meeting with Dr. Jandali that he would be my surgeon. He was beyond thorough in his explanation of the whole procedure from start to finish and I could tell he would be overly cautious to prevent infection or any chance of something going wrong. He is a perfectionist in every sense of the word. In addition his staff was always so personal and professional and available to answer any and all questions.

After being diagnosed with breast cancer I was scared. I immediately felt at ease when I had my first visit with Dr. Jandali. He explained everything in detail about the breast reconstruction I would be having and made me feel at ease. On surgery day his amazing PA Brielle made sure I knew she was right there in the operating room with me and held my hand to comfort my anxiety until I was asleep. I’m so happy with my results after only 1 week post op. The entire staff is so friendly.