Primary Lipofilling as an Adjunct in Transverse Upper Gracilis Flap Breast Reconstruction

In many centres, the myocutaneous transverse upper gracilis (TUG) flap represents an alternative choice in autologous breast reconstruction when abdominal tissue is unavailable. However, a single TUG flap may be volume deficient, particularly in the upper pole. We describe the application of simulta...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2023-11, Vol.86, p.1-7
Main Authors: Sharp, O., Johal, K.S., Morgan, M., Ramakrishnan, V.V.
Format: Article
Language:English
Subjects:
Algorithm
Breast reconstruction
Lipofilling
Microsurgery
Transverse myocutaneous gracilis
Transverse upper gracilis
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Summary:In many centres, the myocutaneous transverse upper gracilis (TUG) flap represents an alternative choice in autologous breast reconstruction when abdominal tissue is unavailable. However, a single TUG flap may be volume deficient, particularly in the upper pole. We describe the application of simultaneous lipofilling to the pectoralis major muscle at the index procedure and present our decision-making algorithm, technique and outcomes. A retrospective review of all TUG flaps between January 2011 and May 2021 was conducted. Patient demographics, volume of primary and any subsequent fat grafting and complications were recorded. 183 patients (242 TUG flaps) were included in this study. Of these; 130 patients were reconstructed with single TUG flaps, 16 patients received a single TUG flap with immediate lipofilling and 37 patients underwent stacked, double TUG flap reconstructions. Of the 242 flaps there were 2 flaps losses (
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2023.07.043