TUG (transverse upper gracilis) Flap

Some women deposit an abundance of fat along the inner thigh. The excess skin and fat from the upper inner thigh can be used to create a breast. The scar is usually located a little below the inguinal crease, and may be visible in a bathing suit until the scar fades. The TUG and TUT flap are two techniques that can be used with medial (inner) thigh breast reconstruction.

About 60% of the time, the blood vessel that nourishes this tissue (medial femoral circumflex artery) branches into many smaller branches; thus, making it necessary to remove a piece of the gracilis muscle with the blood vessels. When a portion of the gracilis muscle is removed, the procedures is called a TUG flap. In contrast to the rectus abdominis muscle, most patients do not notice a difference in the muscular strength of the leg when a portion of the gracilis muscle is removed.

The PAP Flap, based on a different vessel branch in the thigh, has largely replaced the TUG and TUT Flaps because the thigh muscle is not removed for breast reconstruction.

MRA imaging of the inner thigh tissue enables Dr. Vasile to identify the blood vessel characteristics and exact locations of the vessels nourishing the thigh tissue. This enables Dr. Vasile to determine whether it is likely or not likely that a portion of the gracilis muscle will need to be removed. This knowledge can help identify suitable patients and donor sites for surgery.

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