The TRAM (Transverse Rectus Abdominal Muscle) flap procedure uses tissue from the abdomen to reconstruct the breast. In most patients, the TRAM flap provides enough tissue to completely rebuild the breast mound. This procedure is sometimes referred to as a “tummy tuck” reconstruction because it may leave the stomach area flatter.
In an “attached” TRAM flap, skin and fat are lifted from the donor site, and then tunneled under the skin to the chest and shaped into a breast. The new breast remains connected to its original blood supply, and is therefore described as being “attached.”
A “free” TRAM flap is a complete transplant in which tissue is entirely removed from the abdomen and then attached to the breast area using microsurgical techniques that reconnect the tiny blood vessels from the flap to vessels on the chest area.
In either case, TRAM flap surgery is a major operation – three to six hours under general anesthesia for an attached procedure, usually longer than that for a free one. A blood transfusion may be required. The typical hospital stay is two to five days, and normal daily activity can resume after six to eight weeks.
“Who would not be a good candidate for a TRAM flap procedure?”
If you are very overweight, smoke cigarettes, have had previous surgery at the flap site, or have any circulatory problems, a TRAM flap may not be the procedure for you. In addition, if you are very thin, you may not have enough tissue in your abdomen to create a breast mound with this method.
“Would pregnancy be possible after a TRAM flap reconstruction?”
Discuss this with your healthcare team at The Medical Center of Plano, as the harvesting of tissue to rebuild the breast mound could result in temporary or even permanent muscular weakness in the abdominal area.