Transverse Upper Gracilis (TUG) flap for volume replacement in breast conserving surgery for medial breast tumours in small to medium sized breasts.

Excision of medial sited breast tumours in small breasted patients can result in poor cosmetic outcomes, making this a difficult group of patients to manage. Traditional oncoplastic volume replacement techniques available to treat this area of the breast are limited and usually require disruption of the remaining breast to allow access for pedicled flaps. The alternative is mastectomy and total breast reconstruction. The use of a small volume free Transverse upper Gracilis (TUG) flap allows like for like replacement for these defects. Excellent cosmetic results are achievable with minimal breast and donor site morbidity. This initial experience of small volume TUG flaps used in four patients is presented to support the feasibility and assess early outcomes of this technique in the management of this niche group of patients.