TUG Flap Breast Reconstruction in Mumbai
TUG Flap Breast Reconstruction
A Microsurgical Option When DIEP Is Not Possible
Not every woman has enough abdominal tissue to undergo a DIEP flap. For slim patients, athletic women, those who have had previous abdominal surgery, or women undergoing bilateral mastectomy who need two flaps, the Transverse Upper Gracilis (TUG) flap offers an excellent alternative. The TUG flap uses skin, fat, and a small portion of the gracilis muscle from the inner thigh to reconstruct a soft, natural breast and the donor site is hidden in the natural crease of the inner thigh, often improving the contour of the thigh in a manner similar to a thigh lift.
Dr. Rachana Tataria offers TUG flap breast reconstruction in Mumbai at Fortis Hospital, Mulund. She trained in this advanced microsurgical technique during her Breast Microvascular Reconstruction Fellowship at Wythenshawe Hospital, Manchester one of the UK NHS centres where TUG flap is performed routinely. Her FRCS in Plastic Surgery from the Royal College of Surgeons, England, combined with her oncoplastic breast surgery fellowship, allows her to plan complex breast reconstruction with the precision of microsurgery and the aesthetic sense of an oncoplastic surgeon.
What Is a TUG Flap?
TUG stands for Transverse Upper Gracilis. The procedure removes a horizontal ellipse of skin and fat, along with a small portion of the gracilis muscle, from the inner upper thigh the same area treated in an inner thigh lift. This tissue is then transferred to the chest with its blood supply, which is reconnected to vessels in the chest wall under a high-powered microscope. Because the gracilis muscle is a non-essential muscle for walking and leg function, its partial use does not affect daily mobility or strength.
Why Choose TUG Flap Reconstruction?
An option for slim patients
When abdominal tissue is inadequate for DIEP, the inner thigh often provides sufficient soft tissue.
Hidden donor scar
The incision sits within the natural inner thigh crease and is concealed by underwear.
Living tissue
Like DIEP, the reconstructed breast is made of your own warm, living tissue and ages naturally with the body.
Ideal for bilateral reconstruction
Two TUG flaps can be harvested simultaneously from both thighs for women undergoing bilateral mastectomy.
Thigh contouring benefit
The donor site closure resembles an inner thigh lift, often improving thigh contour.
Suitable when abdomen is unavailable
After previous tummy tuck, large abdominal surgery, or significant abdominal scarring.
Who Is a Good Candidate for TUG Flap?
Women with insufficient abdominal tissue for a DIEP flap (typical for slim, athletic, or postpartum tissue-thinned patients).
BRCA mutation carriers undergoing bilateral risk-reducing mastectomy who need a pair of flaps.
Patients with previous abdominoplasty or significant abdominal surgery.
Women in good general health with no significant lymphatic disease in the lower extremities.
Non-smokers, or those willing to stop smoking at least 6 weeks before surgery.
Women seeking small to medium breast volume reconstruction, TUG flap is best for moderate breast sizes.
The TUG Flap Procedure
TUG flap reconstruction is a microsurgical procedure performed under general anaesthesia, typically taking 6 to 9 hours for unilateral reconstruction and 9 to 12 hours for bilateral. The procedure involves:
Imaging and marking to identify the dominant perforating vessels of the gracilis muscle and to plan the skin ellipse design.
A horizontal ellipse of skin and fat with a thin strip of gracilis muscle is raised from the inner thigh, preserving the medial circumflex femoral artery and vein.
The flap is moved to the chest, and its artery and vein are sutured to the internal mammary vessels under operating microscope magnification.
The flap is sculpted into a natural breast mound.
The inner thigh is closed in layers, often producing a result similar to a thigh lift.
Why Choose Dr. Rachana Tataria for TUG Flap in Mumbai
01
Microsurgery fellowship at Wythenshawe Hospital, Manchester University NHS a high-volume centre for TUG and other perforator flap reconstructions.
02
Female plastic surgeon providing comfort and intuitive understanding during a deeply personal surgery.
03
Surgery at Fortis Hospital Mulund, full ICU support for flap monitoring.
04
FRCS Plastic Surgery (UK) and dual fellowships in oncoplastic and microvascular breast surgery rare in Mumbai.
05
Multilingual consultation: English, Hindi, Marathi, Gujarati, Kutchi, Kannada, and French.
06
ERAS-based recovery protocols imported from UK NHS practice.
The Recovery Journey
Initial Monitoring and Recovery Care
The first 24–72 hours are spent in monitored care to ensure healthy flap circulation and healing.
Hospital Stay and Drain Management
Most patients stay in the hospital for 5–7 days, with drains remaining for around 1–2 weeks.
Return to Daily Routine and Work
Most patients can return to desk work within 3–4 weeks after the recovery period.
Long-Term Healing and Final Results
Breast shape, softness, and overall contour continue improving gradually over the following months.
FAQs : TUG Flap Breast Reconstruction in Mumbai
DIEP flap uses lower abdominal tissue; TUG flap uses inner thigh tissue. DIEP is generally the first choice when sufficient abdominal tissue is available. TUG is the preferred alternative for slim patients or when the abdomen cannot be used.
No. The gracilis muscle is a non-essential muscle for leg function. Removing a small portion of it does not affect walking, climbing stairs, or returning to regular exercise after recovery.
TUG flap is best suited for small to medium breast volume reconstruction. For women who require larger volumes, a stacked TUG flap (using both inner thighs for one breast) or alternative techniques may be discussed.
The scar is placed in the natural crease of the inner upper thigh, sitting parallel to and hidden by the underwear line. Most patients find it well concealed even in swimwear.
Yes. Bilateral TUG flap reconstruction harvests one flap from each inner thigh and reconstructs both breasts in a single, longer surgery — often a preferred option for BRCA carriers undergoing bilateral mastectomy.
Most health insurance policies in India cover breast reconstruction after mastectomy, including TUG flap, as part of breast cancer treatment. Insurance verification is done before surgery.
TUG flap results are essentially permanent. The reconstructed breast is your own living tissue, and there are no implants to replace.
Get in Touch with Dr. Rachana Tataria
Whether you’re ready to take the next step or have questions about TUG Flap Reconstruction, we are here to guide you.
Begin your journey toward transformation.