Breast reconstruction (DIEP and TUG free flaps)

The DIEP (Deep Inferior Epigastric Perforator) flap uses skin, fat, and blood vessels from the lower abdomen to reconstruct the breast, while preserving the abdominal muscles. The TUG (Transverse Upper Gracilis) flap uses tissue from the inner thigh, including part of the gracilis muscle, to create the new breast. Both methods involve microsurgery to connect blood vessels but differ in the donor site location.

Ladies who need a mastectomy, either for cancer or risk reducing reasons (like being a BRACA gene carrier), or have had a mastectomy, may be suitable candidates if they have adequate amount of skin and fat on the abdomen. Patients who have had previous abdominal surgeries or those with certain medical conditions may need to be evaluated on a case-by-case basis.

The benefits of DIEP flap reconstruction include a natural look and feel of the breast, preservation of abdominal muscles, a lower risk of hernias or abdominal weakness, and an added benefit of a tummy tuck-like effect due to the removal of lower abdominal tissue.

Previous abdominal surgeries may affect your suitability for DIEP flap reconstruction. Ms Teo will evaluate your medical history and may recommend alternative reconstruction options if necessary.

Because the DIEP flap technique preserves the abdominal muscles, most patients do not experience significant long-term weakness. However, some temporary discomfort and weakness are common during the initial recovery period.

Yes, there will be scars both on the breast and the lower abdomen. The abdominal scar is typically positioned low, similar to a tummy tuck scar, and can often be concealed by underwear or swimwear. Scarring on the breast depends on the specifics of the mastectomy and reconstruction.

The TUG flap is used for breast reconstruction in ladies with small to moderate sized breasts who would like reconstruction using their own tissue and have enough tissue on their inner thighs.

Benefits include a natural look and feel of the reconstructed breast, the use of the patient’s own tissue, and an additional thigh lift effect. This technique is particularly suitable for patients who do not have enough abdominal tissue for other flap procedures

The TUG flap involves removing the gracilis muscle, which plays a minor role in leg function. Most patients do not experience significant long-term weakness, although some temporary discomfort and weakness in the thigh are common during the initial recovery period

Yes, there will be scars on both the breast and the inner thigh. The thigh scar is typically positioned below the groin crease. Breast scarring will depend on the specifics of the mastectomy and reconstruction.

Yes, TUG flap reconstruction can be performed immediately following mastectomy (immediate reconstruction) and lymph node surgery (if indicated).

Breast reconstruction using DIEP or TUG flaps typically offers very natural-looking and feeling results because the tissue used is your own. The reconstructed breast will age naturally with your body and generally provides a more realistic texture compared to implants.

In many cases, breast reconstruction is covered by insurance, as it is considered part of the treatment for breast cancer. This includes reconstruction of the affected breast as well as procedures to achieve symmetry with the other breast. It's important to check with your insurance provider to understand your coverage and any associated costs.

You must not drive for 4-6 weeks after free flap surgery surgery. When all your wounds are completely healed, simulate an emergency brake in an empty carpark. If you feel entirely safe and in control at this stage, then you are safe to resume driving.