Transverse Rectus Abdominis Muscle (TRAM) Flap Reconstruction
Unlike most other methods of breast reconstruction, the TRAM flap is completely natural because it uses your body's own tissue to reconstruct your breast. TRAM, or the transverse rectus abdominis muscle, is the tissue that is used 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 "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 to this type of surgery is that there is a long abdominal scar below the navel and is more painful than other breast reconstructive surgery. It also requires a few more days in the hospital after surgery and significantly 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 believe that they made the correct choice.
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.
Preparing for Surgery
To shorten your recovery time from a TRAM flap breast reconstructive surgery, you may want to familiarize yourself with and follow the suggestions for physical pre- and post-operative exercises below.
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