A TRAM flap uses muscle, fat and skin from your abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached and formed into a breast mound.
TRAM flap reconstruction is one of the many options available to women who need to rebuild and reshape their breasts after having mastectomy.
This procedure is named after the transverse rectus abdominus myocutaneous muscle that is used, along with surrounding skin and fat, to perform this breast reconstruction technique. At Hallmark plastic surgery, the TRAM Flap technique is one of the most popular breast reconstruction options.
Is TRAM Right For You?
If you have undergone mastectomy (complete breast removal) or if you're planned to udnergo a mastectomy (removal of one or both breasts) and do not wish to undergo implant based breast reconstruction, then TRAM flap may be right for you.
However, if you have had previous abdominal surgery, such as a tummy tuck or hernia repair, or do not have enough abdominal tissue to spare, you may not be a good candidate. Additional factors such as obesity, diabetes and recent history of smoking may also affect your suitability for this procedure.
How the Surgery Works
TRAM flap reconstruction is performed with general anesthesia. The procedure takes about 2-3 hours to perform, and if TRAM flap surgery is performed at the same time as your mastectomy, the entire operative period is 4-5 hours.
Skin, muscle and fat tissues are harvested from the abdomen (donor site) and transferred to the chest wall. The blood supply for the donor tissue remains intact and is tunneled under the skin from the abdomen to the chest. Your reconstructive surgeon will then shape the tissues to form a new breast mound.
A tummy tuck is also incidentally performed during TRAM flap reconstruction, so in addition to new breasts, you will also have a firmer, flatter tummy after surgery.
After Breast Reconstruction
Most TRAM flap breast reconstruction patients stay in the hospital for a few days to a week following surgery. Once you return home, you will be instructed to rest and avoid showering for at least 1-2 weeks and wear a non-underwire bra for support.
Have a friend or family member help with aftercare and transport you to and from post-operative appointments while you are on pain medication.
Within two months, your recovery period will be mostly complete, and additional surgeries, such as nipple/areola reconstruction may be scheduled.