The TRAM Flap Procedure is also called the transverse rectus abdominus myocutaneous procedure. A tissue flap procedure will use skin, fat and muscle form the abdomen to create a new breast for a woman, after a mastectomy has been performed. There are several ways that the procedure is done. One uses free or detached tissue while the other uses pedicle or attached and tunneled tissue flaps. The goal of the procedure is to create a natural looking breast, using skin and tissue from the stomach area. The procedure allows for the woman to have a natural looking chest although she does not have any breast tissue in the area.