Inner Thigh Flap (TUG) Anyone?
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Hi there
Well......guess I just wanted to say Hello, im new to this, but this forum has appeared in alot of my google searches and I guess I dont really know what to say other than I feel the need to just comment I suppose to get me started. Silly I know
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hi all..I just wanted to give an update on my TUG since there isnt much in bco for those looking for info..I had a bilateral TUG two weeks ago..10 hour surgery..I was taken back into the OR the next morning for another 8 hrs to repair both blood supplies on each flap that went down.. Wed I was having blood transfusions. I was not allowed zny food or water or ice chips until Thurs. The dopler on my redone flaps stopped again Wed..we are now playing it by ear to see if I need a fhird surgery to remove the flaps..fhey Re still warm but the bottom portion is hard on both sides.. my legs are still very sore 2 weeks out and one is very numb in the knee and inner thigh. Both drains in my legs are still producing 200cc daily..this was and is a hard recovery for me..and if aftrr it all I lose the flaps..it will be for nothing..good news is I like the size and shape of the breasts if they survive..although doubtful...
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hi I'm so sorry your having trouble with your tug. I had mine two years ago. It was a long road. I ended up getting a staff infection in the breasts. They became hard and lumpy. I was so scared it was all for nothing. I pray you can come out of this ok. Please keep me posted. I don't come on the site too often but get the emails. Janet
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LAlady25--
I am so glad to hear all is going well with your TUG flap. I know what you mean about the strange numbness, similar to bee stings or Novacaine, I thought, in my thigh interior and knee cap. I have a few solutions that helped me, and since your outcome and surgical incision was much, much cleaner than mine, this may totally resolve your problem.
The numbness in my legs has never gone away, and I am just now starting to lift weights to build back my strength. My legs post-op were a bit odd--primarily because of the open wounds on my legs and the scar tissue. It wound up making the area above the knee swell to be larger than the inside part of the thigh near my groin--not very attractive and looking more like drumsticks than women's legs. My ankles swell, but less so now than before, and I still have difficulty managing that when flying 3 years out from the TUG surgery.
Here are some things that are helping. The swelling and irritation at the tendon points where my gracillus muscle was removed (knee, quads, hamstrings) improve when I do stretching of my quadriceps, hamstrings, and hip joints. In addition, it helps when I do a standing hamstring stretch and roll out my tendons on the knees, quads, and hamstrings with a roller pin from my kitchen. I was unable to put on pants while standing, but now, after stretching, I'm better able to lift my legs to put them in my pants legs.
Hamstring and quad weight bearing exercises help with the numbness, as well as stretching. Also balance (yoga and pilates) standing positions have helped me to gain strength. Stair stepping is helping my knee muscles improve. I have found that my body tried to compensate for the loss of the gracillus and that it is important to strengthen the other muscles to be able to have a full range of motion with walking up and down stairs.
In two months my PS will be removing all the scar and adhesion tissue from my 13 inch thigh incisions. I am hoping that after that surgery I will be able to get better circulation in my legs and the swelling will stop at my ankles. The revision of the scars is covered by insurance as a keloid scar, and will be done at the same time as my nipple reconstruction.
Recently my heart doc did a stress test and my legs are not able, due to the circulation, to get blood to my heart fast enough which results in super fast hypertension when exercising. The doc says it is a result of deconditioning after the surgery. So I'm making an effort now to really build up my leg strength with weight lifting and CV exercise.
I am still surprised my PS did not recommend using compression pantyhose after the TUG surgery. I recommend using the soft opaque pantyhose for work at low compression (15-20mg) so that it is easy to get on and off. That definitely helps get rid of the numbness and the swelling, and it looks like nice tights instead of compression hose.
Just had my TEs switch to implants, no flap, on 2/14, and I love my squishees! Finally a happy ending to all the surgeries!
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Smiler82 - Let us know how we can help or answer any questions!
warmsmartcookie - Sounds like you are getting along so much better with the implants! Everyone's bodies are so different...Mine were so stressed out by the TEs that I developed severe cording, even though I only had 2 lymph nodes removed. You just never know. I'm so glad that the implants are working out for you!
I am now a little over 2 months out from surgery.
I'm back at work, driving, beginning to work out again and starting to feel like a normal person! My new breast looks great. I saw my oncologist and breast surgeon for my 3 month follow up appointments, and they both raved about my plastic surgeon's work. If any of you are looking to do the flap in the LA area, I would highly recommend Dr. Leif Rogers. He did a phenomenal job. My breast surgeon said that just by looking at it, she would've told me to go get a mammogram because it looks like a totally natural breast. I'm very pleased with the results.
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Hey LAlady25
Many thanks for your kind reply. I guess I dont really know what questions I need to be asking or what im doing lol
Im not a big talker about myself, my role in the family is the strong one who is always there for anybody when they need me and im happy with that. So when i was diagnosed 2yrs ago just after my 29th bday I was so annoyed that this was going to turn me into a vulnerable weak person for everybody to see. I was also highly embarressed, still am, by it all. My family think that is crazy.Im very lucky to have great family and friends around me and my husband is brilliant we have been together 14yrs and thank my lucky stars for him. I didnt tell people if I didnt need too. I had medullary stage 3 I think,lumpectomy, chemo, radio and on Tamoxifen. Since found out I carry the BrCa2 gene. So im on a waiting list to have tug flap reconstruction and im just wanting to find out as much as I can and if you ladies think its the best option and are happy with your results? Do you have any issues with leg strength? I like to run will this be ok? I wouldnt say I was a wimp when it comes to pain so im not really worried about that, im just very insecure about my body anyway and im a massive wimp when it comes to having to show anybody my naked flesh! Honestly it puts the fear into me sooooo bad the thought of all the people in the operating room seeing me in all my glory. I also made the mistake of googling how they put a cathater in! OMG! If I could stay awake through the whole procedure i would just to check im all covered up! Do you have to show much when recovering in hospital? How long were you in for? My doc says 5 to 7days but im hoping to be out after 2 lol Yes people think im crazy! All the normal things people worry about, i seem to worry about the daft insignificant things!
Well considering I said im not a big talker ive certainly waffled on havent I! Sorry ladies, im hoping i dont sound like a dumb crazy lady and I thankyou in advance for your patience with me x
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Hello ladies, thought of contributing to the forum since I gained so much from reading reviews here. I'm 26 this year and diagnosed with breast cancer in Mar 2014, opted for an immediate reconstruction as I didn't want to go through multiple surgeries, reconstruction done by end Mar 2014. I was not a suitable candidate for most flaps. For LD flap, I don't have enough fats. For TRAM flap, as I am young and may want to get pregnant in future, so was advised not to do that as well. So basically I was left with TUG flap which I feel I made the right choice
Surgery was a success and there isn't much functional deficit to my donor site, no things like swollen leg either. The scar is long but doesn't really matter as it is quite concealed. I would recommend going for this procedure especially for young BC ladies!
Take care
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Hi everyone - I'm new to the thread and have found your information and experiences such a huge help! I'm going in for a bilateral mx and TUG recon on July 12th and unfortunately the procedure isn't as commonly done here in Australia; with a lot of women opting for implants. I had a hernia repair/abdominoplasty early last year so I don't have enough tissue for the DIEP flap surgery and implants aren't really my preferred choice.
Its nice to be able to now have some realistic expectations before the big day. Getting a little nervous as to how I'll get through it all but then being BRCA2, 3rd gen on the maternal side and 4th gen on the paternal (male breast cancer) and now having it myself, I'm not leaving any room for it to come back!
Thanks again to all that have shared I'll be sure to do the same with my experience as it unfolds.
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Hi everybody
Im also new to this and have been following it for some time. Im glad you have posted Misspea as im also booked in for this surgery in September and you have prompted me to post. Im from the UK and it hasnt been done at the hospital before so im also very nervous. But like you say BRCA 2 i dont fancy having to get on train again!
Would be great if you kept us informed how you get on and if anybody doesnt mind getting intouch with me with as much information pictures etc I would greatly appreciate it.
Thanks for your time ladies
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Hi Ladies,
I haven't been on these boards for almost a year but I thought I would get back on and start offering support.
I am almost 4 years post diagnosis and I feel amazing.
I have neuropathy from some of the nerves being cut during surgery and reconstruction but I am still happy with my decision and I have very little nerve pain now. And some of the feeling has returned in my breasts and thighs.
I like my breasts (or should I say I like my thighs?). Tee hee hee.
Wishing you all speedy healing.
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Hi all!
Are you willing to share YOUR story of reconstruction? We'd like to feature it in our Acknowledging Our Community Members section on the website!
If interested, please PM us
with a few paragraphs about your experience with Reconstruction -- the
type of reconstruction surgery you chose, how it went, advice you'd give
to others about choosing (or not choosing) reconstruction, and any
other information you could provide to help others in their choices.If you could also include a photo of yourself or something representative of you, we'll include that with the story too!
Please
send to us, the Mods, ASAP as we'd like to finalize this section in the
next week or so. Thanks so much for contributing -- your story will
help inspire others!!!--Your Mods
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Around 2 years ago, I had a TUG flap done prophylactically because I have the BRCA2 gene. I recently took up swimming again after a decades-long hiatus and have discovered that my legs sink like a stone, and I have to work hard to keep them up! I wondered if it's at all connected to my surgery, since fat is buoyant, and fat tissue is removed from the inner thighs for this procedure. My surgeon says he's never heard anyone report that and does not believe they are connected.
Wondering if anyone else has experienced something similar?
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Ima - if you haven´t swum for decades I think it more likely it is because your body is simply not used to the exercise - swimming seems so easy but it takes a lot of energy to do it and we can take it for granted a bit, try building up gradually. Also it may be that you have less strength in your top half so your bottom half has to work harder........I don´t think less fat has anything to do with it to be honest
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What a wealth of info. Read about the PAP flap too. Doesn't muscle which I read would atrophy later. So volume it provides would decrease. Anybody had the PAP who has BCBS?
2014 DCIS 1mm
2 lumpectomies both dirty margins
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I am considering a TUG flap (not enough fat in belly area). My other option is an implant. Surgery will be most likely mid September. I am located in the L.A. area and the plastic surgeon is Dr. Leif Rogers. From what I understand this will be an involved procedure, but the advantages of having a permanent recon that is made up of your own tissue is so appealing. If you have had experience with this surgery or are considering it and wouldn't mind sharing, that would be great. Any input is greatly appreciated. I am also reading through previous posts.
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Hi mye,
I had this surgery in April 2011 and I'm still happy I've had it. My breasts are completely natural and they look so good. My parter and my friends agree.
My only problem was one of swelling - fluid building up and infection in the inner thigh. It is very common, I believe. Keep wearing the tight pants they tell you to wear - the stretchy girdle thing - it helps with the swelling although it is very uncomfortable.
Ensure your surgeon has done this before (mine was very experienced). It is a long procedure. I was in surgery about 20 hours - but I had to be taken back in and opened up again because a clot formed in one of my thighs. I was in hospital about 5 days but when I left all of the drains had been removed
I did really well for a 50 year old woman.
Good luck. Let us know if you have any more questions
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Lifelover, thanks so much for responding. It seems like this surgery is quite rare. 20 hours surgery, wow! and I thought 8-10 was already a pretty long, what an ordeal. I am glad that it was all worth it!! Per my PS this surgery has VERY good aesthetic results. About infection, my doc also mentioned that the infection rate is pretty high because of the location of the scar being between the legs. Must have been super uncomfortable. How long it it take you until you were able to walk/drive etc? I have a little one at home, I'm wondering how long I'd need to take a break...I am still on the fence whether to go for it or not. One last question, do your PS put a tissue expander in first? Thank you again much for your feedback. So helpful to hear first hand from women that have been there.
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I walked out of the hospital - so 5 days post. I couldn't drive for at least a couple of weeks though. I didn't have the strength. I was able to do things around the house immediately (cooking) but I could not lift things - actually I could but you shouldn't because you don't want to ruin any of the good work done by the surgeons
My husband would get out all the cooking things I needed so that I could be creative in the kitchen. Cooking took my mind off of my discomfort. I only needed an over the counter painkiller (I took paracetamol - UK).The worst of the recovery was wearing the girdle thingie - but I suffered with swelling because I didn't wear it as long as they said to. In hindsight, I should have worn it all the time because I had a lot of swelling, sometimes with infection but sometimes when I didn't have infection only swelling, and they put a needle in to drain the infection, I would get an infection from having the area open again.
I did not have a tissue expander put in. It wasn't given to me as an option. I had my BMX and recon in the same op.
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I am new to this thread also. I had a DMX in August and TE's put in at the same time in preparation for later implants. The process was started and already my right breast is contracted due to radiation 6 years ago. Now I find I will need radiation again in that same area once chemo is done. I learned then that radiation and implants do not do well together. I have consulted a Phoenix surgeon who does DIEP Flaps but liposuction years ago ruled that out. Nothing abdominal. He doesn't do TUG and recommended that he do a latissimus dorsi. Now I find that isn't microsurgery. Is it any better for irradiated skin than an implant? You guys are convincing me I should find a doctor who could do the TUG procedure. Any insights???
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Hi Sedona-
Welcome to BCO! We hope you find the support and answers you're looking for here.
This is a bit of an older thread, so there's a chance you might not hear back from contributing members. We would suggest heading over to our Latissimus Dorsi forum for some insight into that procedure, and connect with members there. This is a very knowledgeable community; chances are, if you have a question, someone here has the answer!
The Mods
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sedonabarb, I had a recurrence in the skin after having this tug surgery. I had a lumpectomy and radiation on the reconstructed breast. They weren't sure how it would hold up after radiation but I can't tell one bit of difference. My tug was about 2.5 years established. Now that's probably a reverse order of what you would like to do but maybe a good sign. It wouldn't hurt to have a consult with a doc who does additional types of surgeries.
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thank you for your post. It gives me a boost of confidence. I am trying to contact someone in Phoenix who does a wider variety of these procedures so they can line out the pros and cons. So far, I have not gotten in to see anyone except a tram flap doc, and that's all he does of the microsurgery group. But I'm working on it.
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Hello Ladies who've had the TUG flap done. How are you doing? What kind of exercise are you able to do and do you feel that you have any restriction in your leg muscles?
I started running about 3 or 4 months ago and I'm surprised at how well I'm doing without my gracilis muscles. I do have a lot of fatigue in my legs but I feel better when I take a day off between runs.
Anyone else run or bicycle etc?
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Hi, Lifelover. I'm doing well and glad to see you! I honestly do not notice any difference at all as far as the legs/ I walk a lot and I ride my bike. I have tried to run about once a week but it makes my left hip bone hurt a little so I was afraid to do damage and only do it once a week. I certainly don't think that has anything to do with the surgery.I'm exercising 4 to 6 hours a week most of the time.
I'm active on the "Let's Post Our Daily Exercise" thread. Come on over if you want good company and motivation!
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Thanks Two Hobbies. Really good to hear from you. I'll give the exercise thread a try. Well done with your exercise routine!
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Hello everyone, I am considering doing PAP or TUG reconstruction, despite hearing some bad stories. I'm wondering how the recovery has been, particularly in the longer term. (Though I'd be happy to hear more recent stories too!) It sounds like some of you have regained strength and flexibility in your legs. Can you really do yoga? Also wondering in particular how those of you who had radiation are doing. Did you have prophylactic PAP or implants to the other side? How do they compare visually and comfort wise? I would really appreciate hearing more about this option to help me make an informed decision. Thank you all, Honeybadger
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Hi Honeybadger, I had double mastectomies in March, 2015 with Dr. Robert Allen in NYC -- one was due to cancer, and one was prophylactic. I also had previous radiation to the cancerous breast many years ago (I've had two bouts with breast cancer and am BRCA1+). I am extremely happy with the results, and the donor sites don't prevent me from any activities. Sure, I can feel a little pulling at the back of my legs when I'm doing heavy stretching, but very tolerable -- and it's getting less and less as time goes by. I speed walk 4 miles every day and I do a weight workout at the gym a couple of times a week without any problem. On rare occasion I feel a tiny bit of pain in one of the legs near the scar (usually happens after a period of inactivity ironically), but those incidents are few and far between (maybe 2 or 3 times a year). Honestly it's really nothing, but I mention it just to give you full disclosure. I didn't find the recovery from surgery to be that bad, and it was much less painful than I anticipated. I am so happy I went ahead with the surgery! Feel free to PM with me, and we can exchange phone numbers, if you want to speak further. I'd be happy to elaborate.
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