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Published on: January 11, 2016
The transverse myocutaneous gracilis flap: technical refinements.
Adel Fattah1, Andrea Figus, Bhagwat Mathur
1St. Andrew's Centre for Plastic Surgery, Broomfield Hospital, Court Road, Chelmsford, Essex, CM1 7ET, UK. adelfattah@doctors.org.uk
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|January 10, 2009
Summary
The transverse myocutaneous gracilis (TMG) flap offers a viable alternative for breast reconstruction, particularly for smaller breasts or as a secondary option. Refinements enhance its volume and minimize donor site issues.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncologic Surgery
Background:
- Autologous free tissue transfer is a preferred method for breast reconstruction.
- The deep inferior epigastric perforator (DIEP) flap is the current gold standard.
- The transverse myocutaneous gracilis (TMG) flap is a newer option with limited published data.
Purpose of the Study:
- To evaluate the authors' 2-year experience with TMG flaps for breast reconstruction.
- To assess indications and outcomes of TMG flap breast reconstruction.
- To introduce technical refinements to expand the TMG flap's utility.
Main Methods:
- Prospective data collection for TMG flaps performed between January 2006 and December 2007.
- Review of indications and outcomes.
- Revision and standardization of surgical technique.
Main Results:
- 19 TMG flaps were performed in 12 patients over 2 years.
- One flap was lost postoperatively; follow-up ranged from 6 months to 2 years.
- Technical refinements were detailed to improve flap harvest, volume, inset, and minimize donor morbidity.
Conclusions:
- The TMG flap is suitable for small-to-moderate breast reconstruction as a primary option.
- It serves as a secondary option for larger breasts when DIEP is not preferred.
- The TMG flap is a reliable salvage option for failed previous reconstructions.
