The most common flap procedures for breast reconstruction are DIEP flap and TRAM flap, which utilize the tissue from the abdomen. In some instances, natural tissue reconstruction is performed using tissues from areas of the body besides the abdomen.
The alternative donor site procedures include:
- Latissimus Doris: muscle next to the shoulder blade
- SGAP Flap (Superior gluteal artery perforator): tissue from the top of the buttocks
- TUG Flap (Transverse upper gracilis): tissue from the inner upper thigh
Generally, your surgeon will recommend one of these procedures when the abdominal tissue is not suitable for use in reconstruction. They may also be used in cases where the abdominal tissue was previously used for reconstruction. With the exception of the shoulder blade donor reconstruction (Latissimus dorsi), these additional flaps are all performed as free (microsurgical) procedures.
Latissimus Dorsi Flap Reconstruction
One of the available donor site options for breast reconstruction is the latissimus dorsi muscle, or the muscle next to your shoulder blade. The flap tissue, muscle and skin are "tunneled" around from the back of the body to the front and are placed at the mastectomy site. Because there may not be enough "filler" in this area of the back to match the size of the other breast, this procedure may also require the placement of an implant.
The surgery may leave a large scar visible on the back and a scar on the newly reconstructed breast. This type of reconstruction avoids the potential "flap death" associated with free TRAM and DIEP flap procedures. Your surgeon can discuss the risks and options with you during your consultation.
SGAP Flap Reconstruction
One of the available donor site options for breast reconstruction is the superior gluteal artery perforator tissue, or the SGAP flap. This issues the tissue from the top of the buttocks. Your surgeon will work to maintain a natural contour to your buttocks while taking the donor tissue. There will be a scar on the buttocks and on the newly reconstructed breast.
TUG Flap Reconstruction
One of the available donor site options for breast reconstruction is the transverse upper gracilis tissue, or the TUG flap. With this procedure, a new breast is constructed using the tissue from the upper thigh near the groin and from the gracilis muscle, which is the muscle that helps pull legs inward. Your surgeon would likely recommend this if you have smaller breasts that will not require as significant of tissue volume to appear natural. Because of the location of the donor site, the scar is very well hidden. In addition, few patients feel significant effects on their comfort or function from the change in the gracilis muscle.
Your surgeons and care team
The plastic surgeons and care team members who perform breast reconstructions and help patients recover from the procedure are experts in their field. All surgeons including the plastic surgeons and surgical oncologists work very closely to plan your surgical treatment and reconstruction. All of our surgeons are board-certified in plastic surgery and have years of experience in breast reconstruction procedures. Learn more about the team through the profiles below.
Make an Appointment
If you are ready for a consultation, call 734-998-6022 to schedule an appointment with one of our specialty plastic surgeons.