Tram Flap

The Tranverse Rectus Abdominus Myocuteneous flap utilizes the patients own tissues. Specifically, it utilizes the skin, fat and underlying rectus muscle from the abdomen which is then tunneled under the skin up to reconstruct the breast. This is marked out as though the patient is having a tummy tuck as an elliptical incision on the abdomen. After closure, this leaves a scar on the abdomen from hip to hip and a scar around the belly button.

The skin, fat and muscle of the abdomen is tunneled up and sewn in to the old mastectomy scar superiorly and inferiorly into the lower breast fold. The flap remains attached to the body during the entire procedure. This produces a soft, natural appearing breast with natural ptosis (droop). This is a good option for larger breasted patients with a BMI<32, who do not smoke, have extra abdominal tissue and no previous abdominal surgeries.

The surgery takes approximately 3.5 hours and the patient stays in hospital for approximately 3 days. The recovery is 8-12 weeks.

Possible complications include flap necrosis, hematoma, infection, DVT/PE, wound healing problems, asymmetry, and abdominal hernia or bulge.