Breast Reconstruction TRAM FAQ

What is TRAM flap reconstruction?

TRAM (transverse rectus abdominis flap) is a procedure to reconstruct the breast using skin, fat, and the muscle. Using this reconstruction method, the surgeon designs a tranverse flap of skin and fat on the middle to lower abdomen. The tissue for the new breast is surgically freed from the abdomen but left attached to the vertical abdominal wall muscle (the rectus abdominins.) The abdomen is closed by bringing the remaining muscles together to restore abdominal wall strength. Surgical mesh or Alloderm (cadaver skin dermis) are used to reinforce the abdominal wall. The flap is then elevated and transferred to the chest wall area. TRAM flap reconstruction can be used for immediate or delayed reconstruction.

Who is a good candidate for TRAM flap reconstruction?

The best candidate for TRAM breast reconstruction is someone who has enough abdominal tissue to reconstruct one or both breasts. Patients medical history will determine is this procedure is best for you.

Where is the scar from TRAM flap reconstruction?

There are two scars from TRAM flap reconstruction. One is on the abdomen extending from hip bone to hip bone (similar to a tummy tuck scar); the other is on the reconstructed breast and usually is circular shaped.

What are the possible risks of TRAM flap reconstruction?

Potential risks include bleeding, infection, seroma, pain, scarring, numbness, asymmetry, hernia formation, hematoma, DVT, partial/total flap loss, abdominal necrosis, and need for additional surgery. Dr. Sood will discuss these risks further during your consultation.

How long is TRAM flap reconstruction?

TRAM flap reconstruction usually takes 3-4 hours.

What is the typical recovery time for TRAM flap reconstruction?

A hospital stay of 2-3 days will be required dependent on your recovery from surgery and other medical problems. You will be sent home on pain medicine and antibiotics. You will have surgical drains in place on the reconstructed breast and in the abdomen. You will need to be off work for 4-6 weeks dependent on the type of work you perform. You should not do any strenuous activity for at least 6 weeks following this procedure. You will be on 10 pound lifting restrictions for the first several weeks following surgery.

When do I return for a follow up visit?

You will be seen while in the hospital as well as within a week of being sent home. From there Dr. Sood will determine when you need to follow up.

How long before I can return to work?

Most patients are able to return to work in 4-6 weeks depending on the work requirements.

How long before I can return to normal activity?

Most activities of daily living can be resumed within a few days. You will be given a 10 pound lifting restrictions for the first 4-6 weeks following surgery. It is important to get up and move around within a day of surgery to help decrease the chance of developing a blood clot. Strenuous activities should be avoided for about at least 6 weeks or until Dr. Sood has given you clearance.

Dr. Sood's primary goal is to provide excellent clinical results along with a high level of patient care and service. Patient satisfaction is our highest concern. We are dedicated to providing every patient with a pleasant experience, beginning with the first visit and continuing on through surgical procedures and treatments and postoperative care. We encourage patients to evaluate the benefits as well as the risks of each procedure within the confines of realistic expectations.