Hello has anyone had a mastectomy and reconstruction using a single inner thigh flap? If so would you please share your experience post surgery. How did you cope post surgery, is your thigh noticeably thinner? Any tips? Any complications you wish you knew about? My plastic surgeon has recommended for me as I do not have enough tummy fat.
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Hi i cant help with the tug flap but i did have an LD flap 21 years ago because i didnt have enough tummy fat!
I think id have plenty this time round if i had to have a new reconstruction!
I expect youll have a few similarities in the sense that youll probably get some numbness both in new breast and donor site. Will you need an implant as well? Be prepared for tingling and nerve pain to begin with. I found amytriptyline was the best and with few side effects.
I just wanted to wish you well with your surgery and no doubt youll find someone who can help on here with this kind of reconstruction. Xx
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Hi,
I am booked in for a mastectomy and TUG 19th Aug so I am also interested in replies. I have looked at other reconstructions using a TUG flap to see the before and after photos of the thigh and my BC nurse also showed me a couple of pics.
Have you got the TUG leaflet or discussed it with the surgeon/nurse already? You are advised to spend as little time sitting as possible for a couple of weeks after- I didn’t really process that until I read it in my leaflet.
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Thank you for your reply. I hope all goes well for you on Tuesday. I am waiting for my two surgeons to coordinate a date. X
Hi Benison,
I am now on the other side. Day 5 post skin saving mastectomy and TUG flap reconstruction.
A brief overview with the caveat I’m still on strongish painkillers and have not yet restarted my ADHD meds.
Surgery day- admitted 0730 hrs hardly any waiting to be taken to theatre.
Woke up in recovery some time in afternoon, was on oxygen mask then nasal cannula but can’t really remember when they removed that.
Catheterised. IV fluids and antibiotics. Continuous monitoring of ecg, blood pressure, SA02 (oxygen sats %), heart rate, respiratory rate all by machine
Started regular pain killers plus PRN (as needed top ups) and laxatives as I get constipated just with paracetamol.
Recovery phoned my husband and spoke to him then held phone to me so I could speak to him- I can’t really remember much but he said he was so relieved to hear my voice.
From recovery I was taken straight to Orthoplastics HDU. Apparently this is always the case but I don’t recall being told this pre op so I was a bit shocked when I worked out where I was. Once the nurse had said that was always the plan I felt much better. They needed to check on the flap every 15 minutes and this would not happen anywhere else due to the ratio of nurses to patients.
In HDU I was still hooked up to all the machines plus the flap was palpated and Doppler checked every 15 mins. Surgeons came in a lot- the flap was not a good colour and they had difficulty hearing the blood flow on the Doppler (like when they listen to a baby’s heart beat, whoosh whoosh) after a while the colour improved and they relaxed a bit and checked me every 30 mins. I pretty much didn’t sleep that 1st night but I wasn’t tired, hungry or bored so I was ok.
I’m going to post this now and continue in a bit as don’t want to loose what I have written.
Part 2.
Day 1 post op.
They need to keep the flap area really really warm, I had an air blanket over/in the vicinity, it was uncomfortable but the nurses and support staff helped position it in most comfortable way eg so it wasn’t blowing on my face.
Lots of visits from doctor/registra/surgeons as well as hourly checks from the nurses.
My groin wound was barely checked as it looked great (as far as surgical wounds go)!
I had “dramatic swelling” on the breast so they got me into the mastectomy bra. I had brought the Asda ones with me and the nurse said they were better than the ones they supply so I am just wearing those. Highly recommend them, pack of 2 for £18 I think it was. I got size M to allow for the swelling and boy I’m glad I did!
Breast didn’t hurt unless palpitated but I had so much swelling. I had more feeling than I thought I would.
Physio came to get me out of bed. My tug donor site (right leg) was the opposite side to my mastectomy (left breast). I also had a leg drain. Not going to lie, getting out of bed was hard and awkward. I had pain in my leg when I stood so I couldn’t put all my weight through. I stood for a few moments then got back into bed, I had agreed with the Physio how I was going to do it but somehow my body didn’t do that and it all looked a bit weird. I am a Physio so it was a very humbling experience being on the other side. We had a laugh about it once I was back in bed.
I’m not sure how much detail will be helpful here as this is my experience and likely different for everyone. Please ask for any clarification or further detail any part.
Catheter was removed this day. It didn’t hurt. At all. It just feet weird. Also had the IV removed so I was hooked up to less things. I was drinking loads of water >2L easily so after a couple of hours I wanted to try use the commode. I needed help from 1 person and I partially stood and pivoted on my left (unaffected leg) and then lowered myself down to commode and tried to lean to the left and support my weight with my right arm. Going back to bed was the reverse. Each time thereafter was a bit better. Thank God!
Day 2 post op.
Same support worker that assisted me to the commode my first time was back on shift (she was my favourite, a real gem), we transferred to the commode and then walked to the sink so I could wash my hands- 3m there and 3m back. When she saw how much I had improved she was so happy! We planned to have a walk to the actual toilet the next time I needed it.
Leg wound looked great. Leg was only sore first couple of times I stood- presumably from the actual surgery, It will have been in some exciting positions for a few hours, and swelling from the operation site. I had some leakage from the leg drain (and still do) which is fine.
Breast started getting tender due to swelling and bruising but the mastectomy bra really helped and I was accepting the PRN pain killers now I was more mobile so it’s not too bad. My shoulder is great- the sentinel lymph node biopsy was harder on my arm than the mastectomy. I have almost full range so early on.
After tea (dinner) I was transferred to a ward. I had a side room with en-suite.
On one of my trips back from the toilet I saw the physio on the ward and she was gobsmacked, I was now independently mobile and fully weight bearing. She came straight over so she could observe me get into bed and she said I was so good she was discharging me from Physio. We had a chat about me getting into my house and up the stairs and everyone was happy with the plan. This was whilst I was on HDU I forgot to add to last post.
Day 3 post op.
I had a really good sleep last night as the side room was very quiet and I was being checked every 4 hours I think.
Surgeon happy for me to be discharged. My leg drain was still getting fluid so not able to be removed prior to going home. I have an outpatient appointment anyway on Wednesday which will be 8 days post op and they will remove it then.
All that day I was resting, I needed barely any input from nurses. I started feeling nauseous because of the heat (whole areas AC had broken down) and the pain killers. So I was glad when my paperwork and meds were completed and my husband was able to pick me up, ended up being 8pm.
Someone from the ward wheeled me down to the main entrance. This was the 1st time I had sat apart from commode and toilet but it was much more comfortable than I had thought. I’m strictly not to sit upright for 1 week so I did lean back and to the side. I walked a few metres to the car and got in independently. The seat was reclined back as far as it would go. My husband forgot the pillow (doh!) but I didn’t need it. I imagine if there was a sharp brake then I would have liked it though. I hit out of the car and walked into house ok 2 steps. I tried to recline in the sofa for a rest but was uncomfortable so went upstairs. Stairs were fine, I went one leg at a time (good leg up first to go up, bad leg down first to go down).
I bought a wedge set and a v pillow for the bed and it’s really helped. I have to change positions regularly.
Day 4.
I slept the best but ended up sleeping past my pain killer time so was out of schedule all day.
Feel better each day.
Did some standing downstairs then sat reclined on armchair with pouffe and managed about ten mins before becoming uncomfortable before going back to bed.
Day 5 (today).
Set alarm for 6am so didn’t miss pain killers and then went back to sleep.
Had a shower and washed my hair, bit of help from husband as I didn’t want to over do it.
Ate dinner stood up.
First day I have bothered using my iPad but I don’t think I could concentrate on a book say.
Hope this was helpful.
Summary and few points I may have missed out:
I can only describe the feeling as brutal for the first 24/48 hours then making steady recovery each hour and day after. I did wonder if this reconstruction was all worth it a couple of times. Which I’m sure is totally normal.
It didn’t hit me for a good couple of hours post surgery, that, I DONT HAVE CANCER ANYMORE. I burst into tears and felt ecstatically happy. Which again I’m sure is totally normal.
Going to toilet is awkward and difficult but gets easier each time.
Looking in the mirror I don’t feel like I have lost part of myself. I only have a circular wound where my areola was, it’s very neat and no dressings. You can see the thigh flap and it feels warm and soft, took a bit to get used to but I gradually looked at it more and more and today looked at my whole self in the mirror and was pleasantly surprised.
My leg wound goes 3/4 around the top of my leg, again very neat, no dressing, and the shape looks good. It is slightly different to my other leg but the reason I picked a TUG was that I do have some inner thigh to spare. One surgeon said not enough tissue to use stomach and another surgeon said he could do it with 2 tummy flaps, hip to hip but I still prefer thing (I actually like my stomach). My BMI is 20, size 10, small B cup, 9ish stone.
I may need some fat transfer in the future if my breast ends up smaller than the other (this much preferable to having a flap from each leg for me).
Happy to answer any questions.
Dear River, thank you so much for posting in such detail. It is incredibly helpful to have your first hand experience. I really appreciate you taking the time to do this during your recovery. I hope it continues smoothly for you xx