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Updated: Oct 10, 2025
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Unilateral breast reconstruction using double transverse upper gracilis (TUG) flaps.
Nicholas M Pantelides1, Romulus Ci Jica2, Nakul G Patel3
1St. Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, CM1 7ET UK; St Andrew's Anglia Ruskin (StAAR) Research Group, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, UK.
Double transverse upper gracilis (TUG) flaps offer a safe and effective alternative for unilateral breast reconstruction when the deep inferior epigastric perforator (DIEP) flap is not an option. This method demonstrates high success rates and reliability for breast cancer patients.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Oncology
Background:
- Autologous breast reconstruction presents challenges when the deep inferior epigastric perforator (DIEP) flap is unavailable.
- The transverse upper gracilis (TUG) flap is an alternative for moderate-to-large unilateral breast reconstruction.
Purpose of the Study:
- To retrospectively review the experience with double TUG flaps for unilateral breast reconstruction.
- To highlight technical considerations and outcomes of this reconstructive method.
Main Methods:
- Retrospective review of 34 patients undergoing unilateral breast reconstruction with double TUG flaps (2012-2020).
- Data collected on patient demographics, surgical indications, operative time, flap weight, and outcomes.
- Analysis of flap orientation and vascular pedicle selection.
Main Results:
- A high success rate of 98.5% (67 out of 68 flaps) was observed.
- Mean operative time was 5 hours 50 minutes, with a mean flap weight of 551g.
- Eight patients required early reoperation, and five underwent secondary lipofilling for contour correction.
Conclusions:
- Double TUG flap reconstruction is a safe and reliable option for unilateral breast reconstruction.
- It serves as a crucial alternative when DIEP flaps are not feasible.
