TRAM Flap Reconstruction

• Images with Explanations
• Tips from other Patients
• Pre and Post-Operative Exercises

TRAM Flap Reconstruction

TRAM stands for transverse rectus abdominis muscle, the tissue that is used to reconstruct your breast in this method. Unlike most other methods of breast reconstruction, the TRAM flap is completely natural, because it uses your body's own tissues to reconstruct your breast.

The advantage of this type of surgery is that the reconstructed breast is very soft, natural and lifelike. Size, fullness and shape are as closely matched for symmetry as possible. In order to reconstruct the breast, we use the "tummy" tissue (skin, muscle, and fat from the area of the abdomen below the navel). This procedure is very similar to a "tummy tuck" which may be considered a benefit for some women. This procedure requires one surgery and a second, very minor one, if you would like your nipple reconstructed. This procedure may be done on women who have had radiation therapy treatment to the breast.

The disadvantage of this type of surgery is that there is a long abdominal scar below the navel and this surgery is more painful than other breast reconstructive surgery. It also requires a few more days in the hospital after surgery and a longer recovery time than other surgeries.

The TRAM flap reconstruction has been performed on women ranging in age from their late twenties to their mid-seventies. After recovery from surgery, most women report that they are pleased with the outcome and they believe that they made the correct choice for them. Most patients do very well and are extremely pleased following their surgery.

The following instruction information is designed to help you know what to expect following surgery as well as to allow you to become involved in your post-operative recovery. Familiarizing yourself with and following these suggestions will be your best preparation for surgery.

	When the skin-sparing mastectomy is finished, all of the breast skin (except the nipple and areola) is saved. The plastic surgeon then can reconstruct the breast by adding the skin needed to replace the nipple and areola, as well as adding breast volume using tissue or an implant. The TRAM flap uses extra skin and fat from the lower abdomen to reconstruct the breast. It does not use an implant. A full recovery of either abdominal or back/shoulder strength is expected.

Tips for patients undergoing TRAM flap reconstruction:

• Two wedge pillows for under the knees and behind the back

• Body pillow, not necessary but helps comfort

• Well stocked library of books, magazines, books on tape and videos

• Telephone by your bed (some women find a portable phone easier)

• Frozen foods and/or easily prepared foods

• Relaxation tapes

• A supportive, non-underwire bra to wear after okay from plastic surgeon

• Have a friend who can wash your hair over the kitchen sink.

• No showers for 5-10 days, so consider alternatives like a sponge bath, a favorite spray cologne or scented powder

• An eye pillow for daytime resting

• Loose overshirts or dresses to hide the drains