The TUG/DUG (transverse upper gracilis/diagonal upper gracilis) procedures are two similar types of breast reconstruction surgery that use a patient’s own tissue from the inner thigh to create a new breast after a mastectomy. Along with the PAP procedure, the TUG/DUG procedures are preferred types of natural reconstruction for slim women who lack sufficient donor tissue in their abdomen or for women who already have had abdominal surgery.
These are two of several autologous (own tissue) breast reconstruction procedures offered at Brigham and Women’s Hospital as an alternative to reconstruction with artificial implants. Like many other forms of autologous reconstruction, the TUG/DUG procedures involve the transfer of a complete flap of tissue – including skin, fat, and its accompanying blood supply – to the chest, where the surgeon re-establishes blood flow to the flap through the guidance of a microscope. The flap is then shaped by the surgeon to achieve a very natural appearance and feel to the reconstruction.
Both procedures involve the sacrifice of a small piece of muscle from the inner aspect of the patient’s leg, but do not result in any long-term functional issues, as the muscle is redundant (not needed). The two procedures differ slightly in the orientation of their scars – the TUG being across the thigh and the DUG being angled down the thigh.
TUG/DUG flaps are typically reserved for patients who do not have enough tissue in their abdomen for reconstruction, or for those who have already had abdominal surgery. The amount of tissue available for transfer in TUG/DUG flaps is typically modest – meaning that it is most ideal for patients with smaller breasts (A or B cup).
You should consider TUG/DUG reconstruction if you:
If you have further questions, please contact us.
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