Transverse Upper Gracilis Flap Procedure
The transverse myocutaneous gracilis flap is a valuable alternative for immediate autologous breast reconstruction after skin-sparing mastectomy in patients with small and medium-sized breasts and inadequate soft-tissue bulk at the lower abdomen and gluteal region.
The flap is constructed with a semilunar skin paddle centered over the longitudinal axis of the gracilis muscle in the inner thigh (see picture). This flap can then be shaped to mimic a breast and provide excellent contour and projection with a consistent blood supply. As with other types of breast reconstruction in Oklahoma City, the TUG procedure is part of a staged approach and more surgeries will be required at a later date for nipple areola reconstruction, as well as making the breasts appear as symmetrical and natural as possible.
Key Facts About the TUG Procedure
- Great option for patients without adequate abdominal donor tissue
- More straightforward than other techniques
- No abdominal postoperative scarring that is associated with other procedures
You may be a candidate for TUG breast reconstruction in Oklahoma City if you do not have adequate tissue in the abdomen or buttocks or if you have undergone previous abdominal surgery, which may have interfered with surrounding blood supply. This procedure is also recommended for women with small to medium sized breasts who do not require a significant amount of volume for reconstruction.
TUG uses your own tissue for a more natural looking breast, provides excellent contour and projection, and allows for immediate nipple areola complex reconstruction at time of surgery, which negates the need for secondary surgery. There’s no abdominal post operative scarring and the loss of the gracilis muscle does not result in hernias, bulging, or significant donor site complications.
As with all types of surgery breast reconstruction does not come without risks. Wound complications at the donor site, wound breakdown (due location around the panty line area), seromas (pocket of clear serous fluid), infection, risk of bleeding, blood clot and pain at the donor site. You should discuss this with Dr. Bajaj to fully understand potential breast reconstruction complications.
Preparing for Surgery
Plan to quit smoking at least 4 weeks prior to surgery and 4 weeks after surgery. Smoking can increase your risk of serious complications and lead to flap failure or wound healing problems. Discuss any medical conditions you have with OKC plastic surgeon Dr. Bajaj prior to surgery so you can know which medications to continue and which ones to stop until after your surgery. Stop taking any anti inflammatory medications at least 4 weeks prior to surgery as these medications thin your blood and may increase your risk of complications after surgery. However, you may take Tylenol for any aches and pains during this time.
If you have not had a mammogram on your breast recently it is advised to get one before surgery to access for any abnormalities. Arrange for someone to be with you, especially in the first couple of weeks after you go home. Remember that you will be laid up for several weeks so try and organize the best you can. Bring items closer to your reach before surgery and down from high cabinets for easier access when you return from the hospital. Keep books, magazines and remotes within reach of your bed. Eat well balanced meals that are high in protein and green leafy vegetables which will help the healing process.
Be prepared to be in the hospital after surgery for 3-4 days. You will also have surgical drains which could range any- where from 2-6 depending on whether one or two breast are reconstructed. These drains will remain in place until they are unproductive or Dr. Bajaj decides it’s time to remove them. The recovery time is anywhere from 6-8 weeks and you will be sore for a couple of weeks, but will improve each day and will eventually be able to return to your normal activity. Oftentimes patients require a final surgery after the TUG flap to make the breasts appear as symmetric and natural as possible. You should discuss with Dr. Bajaj all of your concerns and expectations for post surgery appearance and recovery.
Learn More About TUG Breast Reconstruction
We encourage you to explore your options for TUG breast reconstruction in Oklahoma City. Please contact Bajaj Plastic Surgery in Oklahoma City by calling 405‐810‐8448 to set up a consultation.