35 - Autologous breast reconstruction with medial thigh flaps

Abstract

Autologous free tissue transfer has proved to be an ideal method for breast reconstruction resulting in long-standing and durable aesthetic outcomes. Many women have had previous abdominal surgery, which can damage the blood supply for the deep inferior epigastric perforator (DIEP) flap, or choose not to use the abdomen thus negating the abdomen as a donor site. An alternative autologous option includes the transverse upper gracilis (TUG) flap. The TUG flap is not only useful for women with small to moderate sized breasts with no available lower abdominal tissue but also occasionally for larger breasts. Understanding of the anatomy is crucial in minimizing the potential donor site morbidity. Criticisms of this flap include its short vascular pedicle, limited volume and the donor site morbidity. Double TUG flaps can successful be utilized to moderate to large single breast reconstruction while minimizing donor site complications.