PMC10279530_01
Preoperative view of the patient in an anterior view (middle) and laterally (left, right) demonstrating the adherent mesh graft scars on both sides
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F1
The patient presented with meshgraft scars on both sides of the ventral thorax (Figure 1 (Fig. 1)).
Preoperative view of the patient anterior and posterior: after previous abdominoplasty a DIEP flap was not possible, but there was substantial tissue on both thighs for breast reconstruction.
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F2
She presented with substantial tissue on both medial thighs, so we recommended an autologous reconstruction with a transverse upper gracilis (TUG) flap (Figure 2 (Fig. 2)).
Left: lateral incision during ALT flap raise, two perforators marked preoperatively. Right: demonstrating the undersurface of the ALT flap in the subfascial plane with forceps pointing on the pedicle.
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F3
A large septocutaneous perforator was proximally explored arising from the descending branch of the lateral femoral circumflex artery (Figure 3 (Fig. 3)).
Six months postoperatively: breast reconstruction with TUG flap (left breast) and ALT flap (right breast) in an anterior and lateral view. Donor site on both thighs in an anterior view (right).
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F4
TUG flap was removed, and lipofilling to achieve upper pole fullness in both neo-breasts was performed (Figure 4 (Fig. 4)). The patient is scheduled for the next lipofilling in three to six months.