The bilateral TRAM flap (transverse rectus abdominus myocutaneous) is a tissue flap procedure that uses muscle, fat, and skin from your abdomen to create a new breast mounds after a double mastectomy. There are two ways to do a TRAM flap - as a free (detached) tissue flap or as a pedicle (attached and tunneled) tissue flap.
Bilateral TRAM Flap Reconstruction Procedure
During a TRAM flap reconstruction, skin, fat, and muscle will be moved from your tummy up to your chest, and used to create new breast mounds. A small implant may be used to fill out the size of the new breasts. The most common implant is a saline-filled implant. It is a silicone shell filled with salt water. Silicone gel-filled implants are another common type of implant. Tissue flap procedures use tissue from your tummy, back, thighs, or buttocks to rebuild the breast. The 2 most common types of tissue flap surgeries are the TRAM flap (transverse rectus abdominis muscle flap), and the latissimus dorsi flap. The TRAM flap procedure uses tissue and muscle from the tummy (the lower abdominal wall). The tissue from this area may be enough to shape the breast so an implant may not be necessary. The latissimus dorsi flap is derived from muscle and skin from your upper back. The flap is made up of skin, fat, muscle, and blood vessels. It is tunneled under the skin to create a pocket for an implant.
Bilateral Breast Flap Reconstruction Recovery
Recovery takes three to six weeks and requires follow up surgeries to construct a new areola and nipple. An elastic bandage or support bra minimizes swelling and supports the reconstructed breast. You should avoid active sports, overhead lifting and sexual activity during recovery period. You may have some abdominal muscle weakness but should be able to resume normal activities after recovery. Healing will continue for several weeks as swelling decreases and breast shape and position improve.
Risks of Bilateral TRAM Reconstruction Surgery
Risks of bilateral TRAM FLAP Breast Reconstruction include:
- Long scar
- Navel distortion
- Loss of feeling
- Abdominal hernia and abdominal bulge
Cost of Bilateral Tram Flap Surgery
Cost for bilateral TRAM FLAP breast reconstruction varies depending on the surgeon’s experience and geographic location.
The most experienced doctors who do bilateral TRAM FLAP reconstruction are board certified plastic surgeons and dermatologists. Contact a Board Certified Plastic Surgeon in your area for a consultation, and find out if you are a good candidate for bilateral TRAM FLAP breast reconstruction.