Breast Reconstruction: The Tram Flap
The TRAM (Transverse Rectus Abdominis Myocutaneous) Flap (Pedicle or Free)
During this procedure, the surgeon takes a section of tissue from your abdomen and moves it to your chest to reconstruct the breast. This procedure has also been referred to as the "tummy tuck" procedure because it can leave the stomach flatter than before the surgery.
In a pedicle TRAM flap, you are generally under anesthesia for 4 to 6 hours. A free TRAM flap surgery usually takes longer. You might require a blood transfusion during this procedure. Please check with your surgeon. Generally, TRAM flaps are being used as free flaps rather than pedicle flaps.
There is an excellent blood supply for all regions of the harvested flap tissue. Since it is no longer necessary to take the entire muscle, upper muscle dissection and tunneling can be avoided. Because of this, recovery has been found to be quicker, and free TRAM flap patients are up and moving around sooner than those who have the pedicle TRAM flap reconstruction. Additionally, because the rectus abdominis muscle and sheath are preserved, there is less abdominal discomfort. Please make sure your reconstructive surgeon is qualified to perform the free TRAM flap procedure, as it is highly specialized and requires extensive training, experience, and expertise in microvascular surgery.
The hospital stay is generally two to five days, and you can resume light daily activity around six to eight weeks following the surgery. Some women have reported that it took up to a year to feel "normal" again. BreastHealthOnline recommends that you try to take it easy for as long as you can. The more time you give your body to heal, the better the results. Be good to yourself following surgery, making sure that you remain well hydrated and that your diet contains the proper nutrition.
You will most likely have temporary or permanent muscle weakness in the abdominal area. You will also have a large scar on your abdominal area and on your reconstructed breast.