What is TRAM Flap Breast Reconstruction?
TRAM flap breast reconstruction uses muscle from your abdomen to create a breast. TRAM is an acronym for transverse rectus abdominus myocutaneous, the name for the muscle that is used. This procedure is also often called microsurgical breast reconstruction. Not all plastic surgeons perform microsurgical breast reconstruction, either because they do not perform microsurgical procedures or because they are not skilled at the more intricate requirements of microsurgery.
In a TRAM flap reconstruction, the entire rectus abdominus muscle, skin and fat is “tunneled” beneath the skin to the chest wall to create the breast mound. Since your own body tissue is used, a natural breast appearance results. After the procedure, you will also have a flatter abdomen. Although the abdominal scar extends from hip to hip, it is generally hidden in the panty line. The drawback to TRAM flap reconstruction is that the abdominal wall will be weaker after the surgery, which increases your risk for bulging and/or hernia. I use a mesh when I close the abdominal wall to help prevent this weakness, but in spite of this, abdominal wall weakness will exist because the muscle has been removed.
A TRAM Flap procedure is a one-step reconstruction that takes from 5-7 hours to complete, under general anesthesia, followed by a short stay in the hospital. You will have some abdominal discomfort and tightness, but within 6-8 weeks you can return to normal activities.