Thigh flaps (such as the TUG, VUG, PAP, LTP, or ALT flap) can be a great option for women interested in “natural” breast reconstruction who want to avoid an abdominal scar, or aren’t candidates for a DIEP flap.
Reconstructed breasts created from a patient’s own living tissue provide a “natural”, soft and warm breast that can't be achieved using implants or temporary prostheses. While most patients prefer the DIEP flap technique (which uses a woman's lower abdominal tissue), it typically is not an option for patients who have had previous extensive tummy tucks, who don't have adequate abdominal fat, or who prefer to avoid scarring across the abdomen. For these patients, a thigh flap procedure may be a good option. The "best" thigh flap option will depend on the individual's tissue distribution.
The TUG flap procedure uses skin, fat and the gracilis muscle to reconstruct the new breast. Unlike loss of other muscles (like the rectus abdominus), loss of the gracilis muscle does not result in any noticeable functional impairment. The tissue is dissected from the inner thigh and transplanted to the chest where it is reattached microsurgically. The resulting thigh scar is generally very well hidden near the groin crease. Patients also receive an "inner thigh lift" as an added benefit of the surgery.
Depending on the tissue distribution over the inner thigh, some patients are better served by a VUG (vertical upper gracilis) flap which leaves a vertical scar along the inner thigh instead of a scar along the groin crease.
The PAP flap uses tissue from the upper posterior thigh just below the buttock crease. The final scar is usually very well hidden at or just beneath the buttock crease.
The LTP flap uses tissue from the top of the outer thigh ("saddle bag") and creates a horizontal scar where the saddle bag used to be.
The ALT flap uses tissue from the front outer thigh and leaves a vertical scar.