Patient 6 Gallery

Before and after bilateral breast reconstruction with the TUG flap in a 43 year old breast cancer survivor. Her past surgeries had included bilateral skin sparing mastectomies followed by tissue expander reconstruction, chemotherapy and radiation.  

She had been receiving hyperbaric oxygen therapy for 5 months for a chronic infection of her left breast reconstruction with ADM (acellular dermal matrix) protruding from her wound. She was exhausted, deflated and drained when we met her and just wanted “this to be over”. Unfortunately, she required a staged approach to ensure success after so many past failures.  

Her first procedure was explantation, removal of all infected material from the breast pocket, and allowing her body, mind and spirit to heal. During that time, she reconnected with her family and got fit, active and healthy again. She required tissue to replace the thin, infected skin and had more fat in her inner thighs than her belly – therefore, a TUG flap was chosen over a DIEP flap for her next stage.  

One year later, she returned to the operating room for a microvascular transplant of skin and fat from her upper inner thighs to her chest as bilateral TUG flaps. While we usually strive to complete as many reconstruction steps as possible in one procedure, but this patient required more volume than her inner thighs could offer. An implant was discussed as her second stage procedure to increase the volume of her breast reconstructions.  

One year after her TUG flap surgery, adjustable saline implants were placed under the flaps and nipple areolar reconstructions were completed. The saline implants were later exchanged for smooth round cohesive silicone gel breast implants for the most projection and to get rid of implant rippling in her cleavage area. 

Follow up photos are shown 5 years after surgery with restoration of her body image and a proportional result. She looks back on her multiple surgeries before meeting us and with our team and feels that it was worth it.