Thigh perforator flap (PAP, TUG)
The profunda artery perforator (PAP) flap and transverse upper gracilis (TUG) flaps are techniques that uses tissue from the upper thigh for breast reconstruction. It involves isolation of the perforating blood vessels through the thigh muscles. The flap is then removed and transferred up to the chest. A microscope is then used to reconnect the vessels and blood flow is once again established. The flap is then contoured to create a new breast.
The scar is located at the upper, inner thigh and can be easily hidden. These flaps are becoming a popular option in patients where there is not enough abdominal tissue.