Case-11193 Gallery

Before and after bilateral breast reconstruction revision using the TUG flap. This 52 year old breast cancer survivor had previously undergone bilateral mastectomies, chemotherapy and radiation therapy to her right chest. She had 7 previous surgeries in her home state of Hawai’i, including painful tissue expansion, a failed implant, a right latissimus flap and several unsatisfactory implant revisions.

Her chest muscles were constantly under spasm over her implants and she found it difficult to exercise or use her upper body. She had gained weight and hated her body. Her goal was to get rid of the implants and to have the most normal looking and feeling reconstruction possible. Although she had some lower abdominal tissue (for a DIEP flap), she had more inner thigh tissue available as a donor site. She was an ideal candidate for the transverse upper gracilis (TUG) inner thigh free flap.

Her implants, which were tight, contracted and under the pectoralis major muscles, were removed. Her chest muscles were returned to the chest wall, reconstructing her anatomy. Skin and fat from her upper inner thighs was microsurgically transplanted to her chest as TUG flaps. Postoperatively, she stayed in the Bay Area for a month to recover before flying home to Hawai’i.

A year later, she had her lower abdominal flap of skin removed as a mini-abdominoplasty and was thrilled to have further contouring of her thighs, the sides of her breasts (axillary rolls) and her flaps using liposuction and free fat grafting. Her TUG flap donor sites are hidden from behind in her buttock crease and barely visible in a swim suit from the front.

Following her TUG flap procedure, she drastically changed her lifestyle and took up running and working out. She has had a full body transformation, due in part to feeling like she “now looks not like a breast cancer patient anymore, but a hot 55 year old!”

Her favorite thing is NOT having to wear a bra, and her cleavage which is indeed natural! See the last image to see her in clothes. She is considering having 3D nipple and areola tattoo in the future to complete her reconstruction.