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The TUG (transverse upper gracilis) flap is a relatively new flap for breast reconstruction that provides an alternative to the TRAM, DIEP, or latissimus flap procedures.

The TUG breast reconstruction utilizes skin, fat and a small piece of muscle from the inner thigh, called the gracilis, to reconstruct the breast. Fortunately, the gracilis is one of four muscles that perform the same function – pulling the thigh inwards – and so it can be spared without significant functional loss. In fact, the gracilis muscle is commonly used in other forms of microvacular reconstruction.

The TUG flap is particularly useful for patients who are not candidates for a latissimus, TRAM or DIEP flap reconstruction, or have had previous problems with these forms of reconstruction.

Disadvantgaes of the TUG flap include possible wound healing issues in the groin area, lower leg swelling, and a smaller volume flap than what can be achieved with the TRAM or DIEP flap. Like any microsurgical breast reconstruction, there is also the small possibility of interrupted circulation to the flap.

To learn which form of breast reconstruction is right for you, review photos, or testimonials please visit us online at

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