TUG Flap

Breast cancer treatment often requires the removal of part, or the complete breast through a surgery called mastectomy. Many mastectomy procedures are followed by reconstruction of the breast tissue that is removed. The breast can be rebuilt using breast implants made of silicone gel or saline, or tissue taken from another part of the body. Transverse Upper Gracilis (TUG) Flap is a widely used microsurgical method for post‑mastectomy breast reconstruction. The breast tissue is reconstructed using tissue from the inner upper thigh region and the gracilis muscle (muscle near the groin crease).


TUG flaps are indicated in young patients with small to medium sized breasts, those who do not require a large amount of tissue for reconstruction and those whose inner thighs touch. It is ideal for patients who lack sufficient skin and tissue in the buttocks or abdomen for reconstruction, or in those who have undergone previous abdominal surgeries. TUG flap is the best choice for women who are planning to get pregnant, those who smoke, or who have diabetes and circulatory diseases.


During breast reconstruction using TUG flap, your surgeon will make an oval incision on your upper thigh and will remove the garcilis muscle along with blood vessels, fat and surrounding skin. This is then transferred to the chest region where it is formed into a breast. The blood vessels are matched to those in the region of the chest where they are reattached. The size of the blood vessels is usually less than 1mm in diameter and hence this procedure is conducted under high magnification with the use of surgical glasses and a microscope for clear visualization.


  • Recovery: After a hospital stay of 3-4 days, you will be able to walk with minimal assistance. Your operated thigh would initially feel tight with a little discomfort. Pain and discomfort fades away as healing progresses and you will be able to resume your normal activities within 4-6 weeks.
  • Appearance: Your plastic surgeon takes all the necessary measures to meet your post-surgery expectations of symmetrical breasts that look and feel natural.

Risks & Complications

As with all surgical procedures, TUG flap reconstruction is associated with certain risks and complications. Some of them include:

  • Formation of lumps or scar tissue
  • Infection
  • Delayed wound healing
  • Tenderness or sensitivity to touch
  • Tissue breakdown: death of transplanted tissue due to insufficient blood supply


The advantages of TUG flap include:

  • Scars are concealed and not evident
  • Negligible death of donor site (from where tissue is taken for reconstruction)


The disadvantages of TUG flap include:

  • Lymph fluid leakage and retention (lymphedema)
  • Wound dehiscence (rupture of wound along surgical sutures)
  • Inadequate tissue to reconstruct large-sized breast

Your doctor will weigh the advantages and disadvantages and suggest the best surgical intervention for breast reconstruction.