TUG Myocutaneous Flap (Transverse Upper Gracillis Myocutaneous Flap)
The TUG flap is a reconstructive flap harvested from the medial thigh that includes skin, fat, a portion of the gracillis muscle and the blood vessels associated with it to keep it alive. This flap is a relatively easy microsurgical flap to elevate but can be associated with a more difficult microsurgical connection to the internal mammary vessels.
More concerning is the location of the donor site as it has been associated with wound healing problems and lower extremity lymphedema.
Dr. Marga has experience with TUG flap microsurgical breast reconstruction and uses it as a high-risk reconstructive method for those patients who have limited flap donor sites.
She is interested in performing a vertical medial thigh flap based on the gracillis muscle as this orientation is more complementary to the aesthetic unit of the upper thigh and may avoid the problems with wound healing and leg swelling.
Please feel free to contact Dr. Marga if you are interested in this form of microsurgical breast reconstruction especially if you would be willing to attempt a “VG” flap! Reconstructive Stages of a VG flap would be similar to other microsurgical flaps with Stage 2 revisions, nipple reconstruction and Stage 3 areolar reconstruction.