Transverse Rectus Abdominus Myocutaneous (TRAM) Flap Reconstruction
In a Transverse Rectus Abdominus Myocutaneous (TRAM) flap procedure tissue is taken from the lower abdomen and used to help create the look and feel of a natural breast.
The stomach muscles ("6-pack") from one or both sides of the abdomen, along with the overlying fat and skin, are transferred from the lower abdomen to the chest.
The breast mound is created by tunneling the muscle, skin and fat as one unit to the mastectomy site. The end result is a breast incision that is circular or oval; the skin within the scar was once from your abdomen. The abdominal scar will run from hip bone to hip bone - this scar may be concealed by undergarments - there also will be a small scar around the bellybutton. Patients may benefit from this procedure as the end result essentially mimics a “tummy tuck."
There are two types of TRAM flap procedures:
During a Free Flap procedure, skin, fat and muscle are removed from the lower abdomen and transplanted to the mastectomy site. Using microsurgery, the blood vessels are reattached to the existing blood vessels in your chest. As a result of this procedure, patients experience less muscle loss and improved blood supply.
During a Pedicle Flap procedure, skin, fat and muscle are tunneled from the lower abdomen to the mastectomy site. The purpose of this procedure is to retain the muscle which sustains the original blood supply for the new tissue site.