Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

The breast can be reconstructed using tissue from the thigh, buttock or other areas of the body

Overview
Although the tummy and back are the most common areas to take skin and fat from for a breast reconstruction, it is also feasible to take it from other areas of the body. The most commonly used alternatives are from the inner thigh (known as the Gracilis or TUG – Transverse Upper Gracilis) flap or from the buttock (S-GAP or I-GAP flap). Other options include the posterior, thigh and flank called the Rubens flap. If you are considering a breast reconstruction, Stephen McCulley will discuss the best areas of the body to use for treatment during your consultation.

Procedure In BriefButtock
The operation involves taking wedges of skin and fat from either the upper buttock (S-GAP) or the lower buttock (I-GAP), which is Stephen McCulley’s preferred option. It is also performed with the use of microsurgery techniques. The fat from the buttock is firmer in most patients which could leave a slightly harder feel to the reconstructed breast. However, for the right patient this can be a good alternative in the absence of other options.

Procedure In BriefInner Thigh or  TUG Flap
This operation uses the roll of fat on the upper inner thigh. It leaves a scar that will be just below the groin crease from the front to the buttock crease. The tissue is transferred to the breast with microsurgery techniques and has a 95-99% success rate.

This operation is only able to build a small to moderate breast and therefore is not suitable for all patients. It is sometimes used to reconstruct part of the breast. However, if the patient desires a larger/fuller breast, it is possible to make the reconstructed breast larger with fat injection methods at a later date.

Surgical Recovery & Final Outcome
– Length of stay in hospital – 3-6 days.
– Length of surgery – usually between 3-5 hours.
– Time restricted to bed – 2 days, in which a bladder catheter will need to be fitted.
– Time to walking – patients should be able to walk after 4 days, and walk without any discomfort after 10 days.
– Time to exercise – patients should be able to exercise after 4 weeks of recovery.
– Time to full recovery – patients should feel fully recovered and be able to return to work by 2-3 months.
– Dressings – patients will wear dressings and/or a pressure garment on the treated area for around 2-4 weeks.
– There is a 1-3% chance of experiencing reconstruction problems – part or total failure of the reconstruction succeeding.
– Please do not hesitate to contact us if you have any questions or would like to obtain costs.