Preparation for TRAM Flap Breast Reconstruction

By Dr. Kathleen Ruddy

If you have one or both breasts removed by mastectomy, you may consider a TRAM flap breast reconstruction to recreate your appearance. The TRAM flap procedure uses muscle, skin and fat from your abdomen to create a new breast mound. Although the surgery can give you an authentic-looking breast, be aware of its limitations.

What are the advantages and disadvantages of the TRAM flap procedure?

A TRAM flap breast reconstruction can significantly benefit your appearance. Because the new breast is made out of your body’s own material, it looks and feels like a natural breast to the touch. The operation also gives you a more slender look, owing to the tummy tuck it involves. However, the TRAM flap procedure does not reverse the mastectomy’s removal of your original breast’s nerves. Thus, your new breast has very little sensation. It is also possible for the flap to die, requiring removal of your reconstructed breast.

What physical condition is ideal for TRAM flap breast reconstruction?

If you wish to undergo TRAM flap breast reconstruction, you must fit certain physical criteria. You do not qualify for TRAM flap reconstruction if you are obese or overweight, as this places you at greater risk for an abdominal hernia. You do not qualify if you are too thin, because your abdomen has insufficient tissue for the procedure. Also keep from smoking, as this increases the likelihood that your abdominal fat tissue becomes scar tissue.

EDITOR’S TIP:

When making the decision to have reconstructive surgery, it helps to talk to women who have been through it. They are a great source of information and may have tips that doctors may leave out.

What should you consider before undergoing TRAM flap breast reconstruction?

Keep certain considerations in mind as you make the decision to receive TRAM flap breast reconstruction. Because your surgeon can only remove abdominal tissue from you once, this surgery is a single opportunity (a subsequent breast reconstruction would require another method). The operation leaves your abdomen with a long scar, which may be a deterrent if you like to wear bikinis. Also, your belly button may be stretched or moved during the TRAM, although your doctor can create a new one for you.

What is the recovery from a TRAM flap procedure?

You may have to stay up to a week in the hospital to recover from a TRAM procedure. Avoid strenuous work, especially heavy lifting, for three to six weeks. Following surgery, you are at risk for abdominal hernia and abdominal bulge. Keep your follow-up appointments with the surgeon to track your condition.

A TRAM flap beast reconstruction can restore the look and feel of your natural breast. Although it is generally successful, it is not without risks and restrictions. Consult with your plastic surgeon to determine if TRAM is the best reconstruction method for you.

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