Reconstruction TUG using 1 02 thighs

Hi am on list for TUG reconstruction after left breast mastectomy using 1 or 2 thighs, depending on breast reduction on other side( involving removing implant and then uplift), Surgeon proposes to do lot in 1 op and even make a new nipple - 9/10 hours surgery. At moment DD will be B?Any one had TUG flap can tell me their experiences. Very apprehensive! Thanks

Hi brenda.edge,
I’m sorry you haven’t yet received a response to your question - hopefully one of our lovely forum members will be along to offer advice soon. I did find the following discussion which might be of interest
All the best, Helena

Today I am 4 weeks post delayed unIlateral TUG op, the op took 4.5 hours. My left thigh was used to make a new right breast, B cup to match the existing one. I spent 2 nights in hospital. I only took paracetamol & nurofen for a few days afterwards.


I am delighted with the new breast size and shape - pert and youthful, warm and soft - and it feels like me. I have a couple of small mildly tender points near the sternum where there are big internal stitches yet to dissolve; otherwise it is pain-free.


My left breast will not be lifted to match until a much later date when any swelling in the new breast has disappeared. The surgeon is hopeful of visually getting a really good match in this way. The new nipple will then be created a few weeks later, followed by tattooing when the nipple has healed.


The thigh healing has been uneventful so far.  BUT I have an incredibly tightly stretched feeling all the way down the centre rear of my thigh to just above the knee. At the moment I literally can’t reach to put on my left shoe and sock without help, nor reach my left foot to wash it or cut my toenails, and I can’t pick things up from the floor. I can sit for short periods (10 mins) but my surgeon isn’t keen on me sitting as the pressure can delay the wound healing. It’s also uncomfortable anyway. I certainly wouldn’t want to drive yet. However I can easily walk 10,000 steps a day with no problem, uphill, downhill and briskly.

 I think that all this is probably very normal at 4 weeks post-op. I don’t want to put you off, just to explain that, if you are like me, you will not be able to do certain things for a considerable period and you need patience. Before the op I was a very sporty person so it is very frustrating not to be able to get back to my sports at the moment.


Before the op I had a prosthesis for 18 months, then had 3 very long consultations with my onco-plastic surgeon before I finally decided to go ahead with the TUG; I was trying to persuade him to give me a silicone implant or a DIEP but he refused as he strongly felt he wouldn’t get the best possible result with these.  It took about a year from the first time I saw him to the TUG op happening.


The op you are considering is obviously bigger and more complex than I have had, and my only advice is not to expect to be able to do very much for many weeks afterwards.


Happy to answer any questions. Good luck with your surgery.



I’ve just posted a pic of my thighs taken today, I’m dress size 12, you can see that the difference between the 2 sides is minimal. You can also see the micropore tape covering the scar. The scar itself is approx 3mm wide now.

Hope this helps.

At 2 weeks I was walking maybe a mile or two with no problem. In fact walking was fine from day one but I was sternly warned not to forget and accidentally step out sideways so as not to open/pull on the scar. I was very careful about lifting for 6 weeks so I made my own meals (sandwich, cups of tea etc) but I didn’t do any family meals involving heavy pots & pans full of water. My partner got everything I needed out of low kitchen cupboards before work and when he got home he picked up anything I’d dropped during the day. He did all the cleaning too. I had to shower in the evening so my partner could put my socks on on the morning before he left for work. I remember it as a fairly quiet 6 weeks full of friends visiting or taking me out to their homes for a lunch standing up in their kitchens.
Did your hospital give you a week-by - week chart of what was permitted? If not I’ll see if I can find mine and post it here.
I was told 6 weeks is the magic time when I can start to get back to normal - driving, sitting etc. And it was correct - at 5 weeks I still could not reach to put socks on and at 6 weeks I could do it.
Hope that is helpful, just take it easy till 6 weeks and walk a bit more every day.

I am now 2 weeks post lipofill to fill a small dent at the top centre of the new breast. The op took an hour under GA and I was a day case, I spent 5 hours in toto at the hospital.
I am pleased with the results but I am expecting that the op will need to be repeated at least once more, in maybe 6 months’ time, as some of the transplanted fat will inevitably die off.
They took fat from rear thigh and hips. The resultant bruising was just under the skin and my rear thigh did look very black and blue. But it looked much worse than it was, it didn’t hurt at all, maybe just a bit uncomfortable to sit on a hard kitchen chair. No pills needed, not even paracetamol.
The top of the reconstructed breast is now filled out nicely and matches the other one very well. I had a bit of minor bruising at the top of the breast, nothing Technicolor there though.
I came out of hospital with 4 tiny plasters on my legs/hips; these were then swathed in thick cotton wadding around the entire thigh from top to knee and held in place by tight crepe bandages, with my own tight cycle shorts over the top. The wadding/crepe fell apart after 5 days. Its purpose was to prevent further bruising. Legs like tree trunks so I could only get loose yoga pants over the top.
At the breast I had 2 tiny plasters over incisions which each had one stitch in, and for 11 days I had to wear a tight chest binder 24/7 which the hospital gave me, to keep the breast still whilst the fat tried to form a new blood supply. It’s important not to allow movement of the breast which could damage this delicate process. I also had to wear firm-hold Spanx power shorts for 11 days to stop further subcutaneous bleeding and to minimise the dents where the fat was removed. These were very effective and I can’t see any dents now.
I am now wearing a very firm hold sports bra 24/7 for 2 more weeks to keep intact as much of the new blood supply as possible and not to shear the blood vessels by movement at all.
For 11 days it was flannel wash only, I wasn’t allowed to get the plasters wet, also I didn’t take the chest binder off as it would hab been impossible to get it back on without help and I didn’t want to allow the breast to move if not absolutely necessary.
Following the 11 day milestone, I could also dump the compression shorts and drive again, but I have to wait a further 2 weeks before going back to normal activities including sports/gym etc and before I can lose the sports bra 24/7.
At 3 months post op I’ll see the surgeon to decide if the op needs to be repeated in 6 months’ time.
Hope this helps!

TUG Activity chart.png

Here is the chart that I was given and followed carefully. Please note the asterisked sections re TUG. Also I should add a word of caution that this plan was suitable for me and may not be suitable for everyone. And that recovery from a bilateral TUG is likely to be more demanding than from a one-sided TUG.

Nevertheless it may be a useful guide for you. But don’t stress too much about it if things take a little longer for you, we are all so individual.

Sorry to hear that you have an area that isn’t healing, this is probably fairly common. I was lucky in that respect. I just kept using the brown tape for 6 months and it all knitted together well.

Hi nicpic. Just wanted to add my experience if of help as make right decision for you.

I was offered immediate recon when diagnosed. A meeting was set up with a plastic surgeon who talked me through my options, advantages and disadvantages of each surgery. He had lots of info, and was able to show lots of pictures of his results which helped me visualise what work was involved, the process and what happens over time to the recon and scars. They need you to be realistic about what’s achievable and how long it takes - it’s a process. My husband came to all appointments with me so he could hear first hand the info and ask his questions too.

I’m 46, size 8-10, B/C cup. DIEP or shoulder were not options for me as I have no spare fat in those places. My options were TUG or implant. I felt I wanted something that was natural and part of me. It will grow and shrink as my body changes over my lifetime. Given my age I was concerned that if I had an implant I’d need further ops when the implant reached its shelf life. Seemed the bigger up front op was better long term to save on future ops for replacements.

I had about 3 meetings with surgeon before op to talk through the surgery in detail and risks. I went to a show and tell event which was invaluable with practical info from nurses and seeing results in the flesh from those who’d had surgery was good to see, hear and understand what’s involved. The event gave me confidence in my decision.

I’ve been very lucky. I had no infections and surgery went to plan. My op was about 7 hrs (single mx, recon and anc). I was rested, physically fit and healthy before my op which helped with recovery. I was in hospital 3 nights. up and walking day after surgery, including stairs. I had my jeans back on 6 days after surgery, dusting and light chores after a week, walking outside within the week, driving at 4 weeks, and ready to go back to work after 6 weeks or so. I went to a dance class again about week 8 - to help regain some of my fitness. You’ll need to do exercises daily to regain flexibility but it all helps you feel your body is making progress.

I’m lucky I had the support of my husband. We don’t have children, so I knew we could both concentrate 100% on my recovery and manage our commitments to suit me. He helped with chores and worked from home for a bit so he was on hand if needed. You need to be selfish to give yourself the best chance possible to get over the op ASAP. I found it helped to have small achievable daily goals to help mentally with feeling every day I was recovering - e.g. today’s the day I’ll cook dinner, have a bath for first time, go outside. Listen to your body - it will tell you when you can move and stretch and when you just need rest.

10 weeks on I’m in a great place physically. My boob has settled, fantastic shape, it’s soft, it wobbles and feels 100% me. I’ll need further 1 or 2 small ops later - to create a nipple plus bit of lipo to make it a bit bigger so I have a matching pair!

For me the tug was the best decision. But it’s a personal choice. Good luck with whatever you choose to do.

Not got experience of this but hope it goes well … sounds an impressive plan and significant change … all the areas seem to have different expertise … this option wasn’t offered to me … but good luck … will be interested to hear how you get on and good you have a date ! x