Recovery after Tram Flap Reconstruction: What to Expect

By Dr. Kathleen Ruddy

Approximately 226,870 women get breast cancer every year, and nearly one-quarter of those people die from the disease, according to the American Cancer Association. To help defeat the disease or to improve the appearance of the affected breast, many people choose to have tram flap reconstruction surgery to remove and replace the tissue in the breast that has been damaged by the cancer cells. If you are interested in tram flap reconstruction surgery, it can help to understand what you might expect from the procedure.

How does the tram flap reconstruction work?

A tram flap reconstruction surgery enables the doctor to use healthy tissue from your own body to reconstruct your breast. To do this, the doctor collects a section of muscle, fat, skin or blood vessels from one area of your body and then transfers the tissue to your chest to construct a new breast mound. The doctor may use tissue from your abdomen, back, thigh or buttocks to complete the procedure. There are two types of flap surgeries. A pedicle flap surgery entails the surgeon cutting some blood vessels to transfer the tissue to the breast while keeping other blood vessels intact whereas a free flap surgery involves the surgeon completely disconnecting the tissue from its blood supply and reattaching the tissue flap to new blood vessels near your chest.

How does your breast appear?

After a tram flap reconstruction surgery, the breast usually has a healthy and natural appearance. Although your breast may not look identical to its previous appearance, the surgery can restore the contour of your new breast so that your silhouette appears similar to the silhouette before the surgery. Also, because blood is still flowing naturally through the breast, it usually feels natural and similar to the way it felt prior to the procedure.

BY THE NUMBERS

There is about a 5 percent failure rate on all tram flap surgeries, in which case the new breast must be removed. That rate is much lower for pedicle flap surgery.

Is there any pain after the surgery?

Although most patients are not in severe pain following the procedure, many patients report experiencing soreness in the breast area. This soreness is a result of the stress caused on the breast during the procedure. This feeling might last for around three weeks, but your doctor can most likely prescribe pain medication to alleviate the soreness.

Do you require a cast or stitches?

The doctor must cut an incision into your skin to transfer the tissue to your chest and to reconstruct your breast. After the surgery, you have stitches on your breast to help the skin remain sealed until it can reattach itself. The stitches usually remain on the breast for up to a month, and you can get absorbable stitches to avoid ever having to get them removed. After the procedure, you might also need to wear a drainage tube on your breast to collect any excess fluids that are leaking from the stitched incision area.

Can you be physically active after the surgery?

The physical and mental stress involved with the procedure causes many patients to report experiencing tiredness and grogginess after the surgery is complete. This feeling of tiredness can last for around three weeks. Due to the nature of the surgery on the chest area, your doctor still might recommend that you refrain from many physical activities for up to two months following the procedure. During this period, the doctor may recommend that you avoid any heavy lifting and that you avoid doing any activities that might be strenuous for your body.

Although breast cancer is a dangerous disease that can impair the health of your body and the appearance of your breast, tram flap surgery can help you defeat the disease or repair the breast that has been damaged by the condition. When deciding whether or not to have a tram flap surgery, it can be beneficial to know what the procedure entails.

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