The medial thigh serves as an excellent reconstructive alternative for women who have a natural deposition of fat in this region. Based on vessels from the medial femoral circumflex system, the transverse upper gracilis (TUG) flap captures the soft tissue from the upper, inner thigh as well as the underlying gracilis muscle, an expendable muscle residing in the medial thigh.
Advantages of this flap include minimal donor-site morbidity, a concealed scar, and constant anatomy. Furthermore, the semicircular shape of the transverse upper gracilis flap permits final shaping of the flap in a conical fashion, similar to that of the native breast. As with abdominal flaps, the adipose tissue of the inner thigh is soft and resembles the texture of the native breast.