Transverse Tensor Fascia Lata Myocutaneous Flap for Microvascular Breast Reconstruction

Abstract

The transverse tensor fascia lata (TTFL) flap is an important alternative flap for autologous breast reconstruction. It is a horizontal variant of the tensor fascia lata myocutaneous flap and contains fat from the prominence of the upper lateral thigh (saddle bag). We present the surgical management of a woman with trochanteric lipodystrophy, who underwent staged bilateral mastectomy and autologous breast reconstruction with TTFL flaps. We discuss technical points in TTFL flap design and harvest. Breast reconstruction was successful and the thigh donor sites had excellent aesthetic contour. There were no complications at either recipient or donor sites. The TTFL flap is an important alternative flap for autologous breast reconstruction when other options are less optimal, and has a secondary benefit of thigh donor site closure with lateral thigh lift techniques. The TTFL flap should be presented as an option for autologous breast reconstruction in women with prominent trochanteric lipodystrophy of the upper lateral thighs.

Breast Reconstruction: Necessity for Further Standardization of the Current Surgical Techniques Attempting to Facilitate Scientific Evaluation and Select Tailored Individualized Procedures Optimizing Patient Satisfaction

“…Alternative flap options include thigh-based flaps also used as stacked flaps, such as the posterior thigh-based PAP flap, the inner thigh-based transverse upper gracilis (TUG) flap, or the newly described TUGPAP, all presented as reliable with low morbidity and satisfactory cosmesis additionally to the first described tensor fasciae latae myocutaneous free flap [2, 18, 19]. In a recent systematic review of breast reconstruction with PAP, TUG, or TUGPAP flaps, TUG flaps had a significantly higher recipient and donor complication rate compared with both PAP and TUGPAP flaps, concluding that the TUGPAP flap is a safe and effective alternative.…”