TUT (transverse upper thigh without gracilis muscle) 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.

About 40% of the time, the medial femoral circumflex artery does not divide into many smaller branches in the muscle, and it is possible to use this vessel without removing the gracilis muscle, called a TUT Flap. 

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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