Tissue from inner thigh


The upper inner thigh is the second preferred location for autologous tissue transfer. Transverse upper gracilis flap (TUG flap) uses the upper part of patient's gracilis muscle. Harvesting of the gracilis muscle does not leave any functional deficit on the lower extremity. It creates a warm and soft breast that lasts a lifetime. It can be used as immediate, immediate-delayed or delayed reconstructions with prior tissue expansion.

Ideal candidates are women with insufficient tissue volume for abdominally based reconstruction or patients who prefer scar on the inner thigh instead of on the abdomen.

Depending on the amount of tissue, your thigh will be tighter, as if you had an inner thigh lift. This often necessitates another procedure, called an inner thigh lift on the other leg, to achieve a symmetrical result. 

General information

Surgery duration: 3- 4 hours

Average hospital stay: 5-7 days

Total recovery time: 4 weeks

When would I be able to move about, walk and drive? 

Patients should expect to be walking multiple times the day after surgery and can gradually increase walking time and distance as they feel comfortable. By day 5, most patients can head home. Driving shorter distances can generally be resumed after 3 weeks.

When would I be able to exercise again? 

After about 4 weeks.

Where will the scars be on my body? 

Scars will be located around the breast, as well as an additional scar on the inner thigh (same as for thigh lift).

Compression garments and bra?

You will need to wear compression pants to prevent fluid accumulation for 3-4 weeks. In the first week or two, it is recommended to wear a sports bra.

Will I need any additional procedures?

Reconstruction is typically finished several months after flap transfer with nipple reconstruction and areola tattooing. To achieve the best result sometimes, additional procedures such as liposuction, fat transfer, procedures for car correction, symmetrisation procedures on the other breast, etc. are needed. A significant advantage of autologous reconstruction is the ability to reshape the breast at a later stage to the best final results with a variety of different techniques. 

Which are most common technique-related complications?


  • Flap necrosis: in rare instances, blood supply through flap vessels is compromised due to thrombosis. The tissue does not receive enough blood and can, if not surgically treated, result in the death of the tissue. The risk is the highest in the first days after the surgery while the patient is still being monitored in a hospital setting.
  • Most common donor site problems are tissue fluid build up and accumulation (seromas) requiring evacuation with punctures and hypertrophic scarring which is managed with scar revision.

How does the procedure look like?

During TUG flap surgery, an incision in your upper thigh near your groin is made. Crescent-shaped section of skin, fat along with gracilis muscle and blood vessels are moved up to your breast area. There the vessels are carefully reconnected using microsurgery using a microscope. This enables the transferred tissue to get blood circulation. The transferred tissue is then appropriately shaped and sewn into place. Surgical drains are inserted into the breast area and the donor area. Either one or both breasts can be reconstructed at the same time using this technique.