In some cases, during the TRAM Flap procedure, there are errors or the skin position does not look normal. This may result in the need for a TRAM Flap repair procedure to take place. In either case, the goal of the procedure is to create a natural looking breast after a mastectomy. The tissue to create the breast is taken from the stomach area of the body, along with fat and skin from that region. Surgeons then carefully mound the skin properly to give it a naturally look. Problems in shape and size may present after some time and this may result in the need for the repair procedure.