The TUG (transverse upper gracilis) flap uses the gracilis muscle, located in the upper inner thigh. This muscle starts at your pubic bone and ends along the inside of your upper leg. The gracilis muscle helps you bring your leg toward your body.
With this procedure, a flap of skin, fat, muscle, and blood vessels from your upper thigh are used to reconstruct the breast. The flap is moved up to your chest to rebuild your breast. Your surgeon carefully reattaches the blood vessels of the TUG flap to the blood vessels in your chest using microsurgery.
Because skin, fat, and blood vessels are moved from your upper thigh to your chest, having a TUG flap means your thigh will be tighter -- as if you had an inner thigh lift.
The TUG flap may be a good reconstruction choice for women who aren't good candidates for TRAM, DIEP, or SIEA flaps because of diabetes or other circulatory disease or for women who smoke or who plan to become pregnant.
The TUG flap is a good option for women with small- to medium-size breasts. If you have larger breasts and your doctor recommends TUG flap reconstruction because of your unique situation, you'll probably need a saline or silicone implant to achieve your desired size.
A TUG flap procedure leaves a scar on your upper inner thigh, but most surgeons will usually tuck into the crease at the top of your thigh. In some cases, the scar might be a little lower and may be visible when you're wearing a bathing suit.
Learn more about TUG flap reconstruction on these pages: