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When it comes to breast reconstruction, there are many technique options for women to choose from. TRAM flap breast reconstruction is one of the oldest methods, using tissue that is very similar to breast tissue, from your own body.

What is TRAM flap breast reconstruction?

The TRAM flap (transverse rectus abdominus myocutaneous flap) technique is the most commonly used method for breast reconstruction. TRAM flap uses the lower abdominal skin and fat to rebuild the breast. This technique works well because this tissue is very much like breast tissue, and therefore makes a good replacement.

Benefits of TRAM flap breast reconstruction

TRAM flap breast reconstruction remains enduringly popular because it uses natural tissue taken from the patient’s own body as opposed to breast implants. For many women who do not want implants, this is an ideal option. TRAM flap reconstructive surgery offers both natural-looking results, and removes some fat from the abdomen.

TRAM flap breast reconstruction surgery details

TRAM flap reconstructive surgery is done under general anesthesia and takes 4 to 7 hours to complete. During the procedure, the skin, fat, and muscle of the lower abdomen is transferred to the chest to reconstruct the breast mound.

TRAM Flap Breast Reconstruction

TRAM flap breast reconstruction techniques

When performing TRAM flap reconstruction, there are two main techniques: pedicled TRAM and free TRAM flap.

Pedicled TRAM

The blood vessels, skin, fat, and muscle from your lower abdomen are tunneled under your skin up to your chest to reconstruct the breast mound. To retain its blood supply, the tissue remains attached to its original location. The “flap”, which includes the skin, muscle, and fat with its blood supply, goes under the skin up to the breast area. This technique is typically a less complex operation that does not take as long as the free TRAM technique.

Free TRAM flap

The blood vessels, skin, fat, and muscle are actually completely cut from the lower abdomen and transferred up to your chest to rebuild the breast mound. Using microsurgery, Dr. Craft will then re-attach the blood vessels of the flap to the blood vessels in your chest, which are located in the armpit. With free TRAM flap reconstruction, patients often heal more quickly and have less risk of losing muscle strength in the abdomen.

Recovery

TRAM flap breast reconstruction surgery requires significant recovery time. We will provide you with detailed instructions and what to expect; however, in general patients will need 6 to 8 weeks to fully recover, with several days’ stay in a medical facility. 

There will be surgical dressings to wear, and drains will be placed to collect fluids.

Strenuous activity, including lifting and intercourse, should be avoided for six weeks to help with healing. You should not take baths, use a hot tub, or swim until your drains have been removed and your skin has totally healed. Patients can expect to experience some soreness, bruising, and swelling in the treated areas for several weeks, and some patients notice a change in breast sensation.

You may also feel tired for the first 2 to 3 weeks. The swelling will gradually subside, but sometimes takes 3 to 6 months to completely go away. 

In the first six months, your breasts may feel firm and look large. This is a side effect of the swelling. In addition, your breasts may feel lumpy due to the scar tissue.

Results

Once you have fully recovered from TRAM flap breast reconstruction surgery, your new breasts will look and feel natural. This is one of the benefits of using your own tissue. Your scars will look better each day, but may not completely fade for one year.

TRAM flap breast reconstruction candidates

The best candidates for TRAM flap breast reconstruction are women who have had a single or double mastectomy, and who have an adequate amount of fat and tissue in their stomach to use in the surgery.

If you don’t have enough fat or if you’ve already had other abdominal surgeries, you are not a good candidate. You are also not an ideal candidate if you plan on becoming pregnant or if you’re worried about losing strength in your abdomen.

Why choose Dr. Craft?

Dr. Randall O. Craft at the Arizona Center for Advanced Reconstruction and Aesthetics (ACARA) brings his years of reconstructive surgery expertise to every procedure he performs. Dr. Craft is an expert in the field of TRAM flap breast reconstructive surgery. As a double board-certified, Harvard-trained surgeon, he has the credentials, the experience, and the artistry to carry out safe reconstructive surgeries that achieve life-changing results. Dr. Craft provides patient-centric, compassionate care with an emphasis on safety and patient wellbeing. To schedule a consultation, please call (602)899-6444 or contact us online.

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