Before and after left microvascular breast reconstruction with a TUG flap and right balancing breast revision in a 67-year-old woman with breast cancer. She had little abdominal tissue available as a donor site for autologous tissue reconstruction (a DIEP flap), but her inner thighs were an appropriate donor site for a TUG flap.
In general, the opposite inner thigh is used as a flap for microvascular breast reconstruction – in this case, the right inner thigh was harvested to reconstruct the left breast. Her left mastectomy specimen weighed over a kilogram, and the right TUG flap weighed nearly nine hundred grams. The left nipple-areolar complex (NAC) was removed during the mastectomy and saved, reapplying it to the breast reconstruction as a free NAC graft.
During the same procedure, a right breast reduction and lift was performed on the right to better match the breast cancer side. She required chemotherapy for several months after surgery and slowly returned to exercise, travel and her normal activities once her energy level came back to normal.
Later, she underwent bilateral nipple-areolar reconstructions with medical tattoo, free fat grafting to the TUG flap to add additional upper pole volume, a right balancing augmentation to add more upper pole fullness to the right breast and liposuction contouring of her left inner thigh to better match the right thigh TUG flap donor site.
Follow up photos are shown 2 years after surgery. She has very acceptable symmetry of her breasts, and she is rarely reminded of the fact that she is a breast cancer survivor.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
