Breast reconstruction is a method of restoring shape and volume to the breasts following a mastectomy procedure. This can be an excellent way to ease the difficult transition a woman faces during this aspect of breast cancer treatment. One option for reconstruction is the TRAM flap method.

The TRAM Flap Method

In TRAM (Transverse Rectus Abdominis Myocutaneous) flap breast reconstruction, the plastic surgeon utilizes a section of the fat and skin and a part or all of the rectus abdominis muscle lying underneath for reconstructing the breast. The rectus abdominus muscle is a muscle located in the lower abdomen somewhere between the pubic bone and the waist.

The TRAM flap is the preferred choice of tissue for the breast reconstruction procedure. This is primarily because of the consistency of the newly constructed breast. The tissue involved resembles the softness and form of the natural breast tissue.

Also, since the tissue is extracted from the patient’s own body, it is unlikely that there will be capsular contracture or foreign-body reactions, which are often reported in breast-implant-based reconstructions.

Types of TRAM Flap Surgeries

In a TRAM flap breast reconstruction procedure, it is possible to transfer the TRAM flap as a pedicle flap or a free flap.

A pedicle flap stays attached during the procedure in order to preserve the blood supply. A free flap, on the other hand, is completely detached for transfer.

It is important to know the amount of abdominal muscle that is going to be utilized in the surgery. The free and pedicle flap options each involve a different amount of muscle tissue.

In the case of a muscle-sparing free TRAM flap procedure, the surgeon uses only a section of the rectus abdominis muscle; this might help the patient retain strength in the abdomen after surgery. In the case of a pedicle flap, the entire rectus muscle is utilized, i.e. one of the four primary muscles in the abdomen.

The Procedure

While doing a TRAM flap breast reconstruction surgery, the surgeon will make an incision along the bikini line. He will remove a section of the skin, blood vessels, muscle, and fat from the lower part of the belly and move it up to the chest to form the breast’s shape.

A free TRAM breast reconstruction surgery typically lasts for about six to eight hours. For all free TRAM flap breast reconstruction procedures, the small blood vessels feeding the new breast tissue will be matched with the blood vessels of the chest. A microscope is used for precise reattachment of vessels.

Recovery and Healing

You will be taken to the hospital recovery room after surgery, and the staff will monitor your body temperature, blood pressure, and heart rate. It usually takes around six to eight weeks for a patient to recover after a TRAM flap breast reconstruction surgery. The doctor might ask you to wear a compression girdle for about eight weeks after surgery.

You will need to take care of three different incisions: around the belly button, in the lower abdomen, and in the breast. You might also have drains in the newly constructed breast, as well as in the abdominal area.

Schedule a Breast Reconstruction Consultation

Double-board-certified plastic surgeon Dr. Wayne Lee is a skilled medical professional with a great deal of experience. To schedule your breast reconstruction consultation, contact our office today.