Breast reconstruction - TRAM flap procedure

What is breast reconstruction - TRAM Flap?

A TRAM flap (Transverse Rectus Abdominis Myocutaneous flap) is a surgical procedure, most commonly employed for breast reconstruction. In this procedure, the breast with cancer is surgically removed, and a portion of abdominal tissue, including skin, fat and muscle is taken from the patient's abdomen and transplanted onto the breast site.

What are the benefits of this surgical procedure?

This procedure is preferred by some breast cancer patients because it has the benefits of an abdominoplasty, and allows the breast to be reconstructed with one's own tissues instead of a foreign implant. It is similar to a DIEP flap breast reconstruction, but involves removing a portion of the rectus abdominis muscle (the six-pack) whereas the DIEP flap removes only skin and fat, leaving the muscle intact. The most obvious benefit is the addition of a newly reconstructed breast, but more specifically, the reconstructed breast in a TRAM flap procedure is composed of your body’s natural tissue, so you are not exposed to the additional risks associated with some synthetic tissues.

How does it work?

An oval section of skin, fat, and muscle is taken from the lower half of the abdomen and slid up through a tunnel under the skin to the breast area. Blood vessels usually remain attached and the tissue is shaped into a natural-looking breast and sewn into place. If blood vessels have been cut, the surgeon reattaches them to blood vessels in the chest area using a microscope to sew the tiny, delicate attachments. The procedure takes about four to six hours.

How safe is the treatment?

The technique is quick and relatively safe. The most common risk to the abdomen with TRAM flap surgery is abdominal weakness, which could result in a hernia. In most cases, patients are able to maintain normal daily routines and physical activities, although, they do exhibit limited ability to do sit ups. Other potential complications include fatty tissue firmness, partial flap loss, or in some cases, complete flap loss. Each of these issues can be corrected with revisionary procedures.