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Updated: May 8, 2026
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Published on: January 11, 2016
Transverse upper gracilis flap with implant in postmastectomy breast reconstruction: a case report
Emilio Trignano1, Nefer Fallico, Luca A Dessy
1Chelmsford, Broomfield Hospital- St Andrew's Centre for Plastic Surgery & Burns, Mid Essex Hospital Services NHS Trust, Court Road, Broomfield, Chelmsford, Essex, UK; Department of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Viale del Policlinico 151, Rome, Italy; Department of Plastic and Reconstructive Surgery, University of Sassari, Viale San Pietro 43b, Sassari, 07100, Italy.
Abstract:
Autologous flaps can be used in combination with prosthesis in postmastectomy breast reconstruction. The deep inferior epigastric perforator (DIEP) flap is considered the preferred choice among autologous tissue transfer techniques. However, in patients with a peculiar figure (moderately large breasts and large thighs with flat stomach), who cannot use their abdominal tissue, the transverse upper gracilis (TUG) flap with implant is investigated as a further option for breast reconstruction. This report presents a patient who underwent the TUG flap plus implant reconstruction. A bilateral skin-sparing mastectomy was performed removing 340 g for each breast. The volume of the TUG flaps was 225 g (left) and 250 g (right). Preoperative volumes were restored by placing under the TUG muscle a round textured implant. No complications occurred during the postoperative period both in the recipient and donor site and the outcomes of the procedure were good. In cases where the use of the DIEP flap is not possible because of past laparotomies or inadequate abdominal volume, the TUG flap plus implant may be considered as a valid alternative.