TRAM Flap Breast Reconstruction

Breast reconstruction using your own tissue without the use of implants is called autologous (referring to your own tissue) flap surgery. An autologous flap procedure uses a combination of skin, fat, and/or muscle that is moved from areas such as your abdomen, upper back, upper hip, or buttocks to the chest where it is shaped into a new breast. Not every woman is a candidate for this type of breast reconstruction, and it is best to discuss the pros and cons of these procedures with your surgeon.

TRAM (transverse rectus abdominus muscle) flap procedure harvests abdominal tissue. This is the most common method of breast reconstruction using the patient’s own tissue. It uses the lower abdominal skin, fat and rectus abdominal muscle. In the TRAM procedure, the harvested flap’s blood vessels are not severed, thereby maintaining the tissue’s connection to the original (belly tissue) blood supply.

Since the patient’s own body tissue is used, the result is a very natural breast reconstruction. Also the patient has the benefit of a flatter looking abdomen.

Is This a Good Option for You?

You should consider a TRAM flap breast reconstruction if you:

• Desire reconstruction using your own tissue
• Do not want or are not a candidate for implant reconstruction
• Have enough abdominal wall tissue to create one or both breasts
• Have not had previous abdominal surgery
• Have had failed implant reconstruction
• Are having immediate reconstruction at the time of skin-sparing mastectomy
• Are having delayed reconstruction following prior mastectomy

More Information?

If you have further questions or would like to schedule a breast reconstruction consult, please contact us.

Breast Reconstruction Words to Know

• Areola: Pigmented skin surrounding the nipple.
• Breast augmentation: Also known as augmentation mammaplasty; breast enlargement by surgery.
• Breast lift: Also known as mastopexy; surgery to lift the breasts.
• Breast reduction: Reduction of breast size and breast lift by surgery.
• Capsular contracture: A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.
• DIEP flap: Deep Inferior Epigastric perforator flap which takes tissue from the abdomen.
• Donor site: An area of your body where the surgeon harvests skin, muscle and fat to reconstruct your breast – commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
• Flap techniques: Surgical techniques used to reposition your own skin, muscle and fat to reconstruct or cover your breast.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Grafting: A surgical technique to recreate your nipple and areola.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Latissimus dorsi flap technique: A surgical technique that uses muscle, fat and skin tunneled under the skin and tissue of a woman’s back to the reconstructed breast and remains attached to its donor site, leaving blood supply intact.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Mastectomy: The removal of the whole breast, typically to rid the body of cancer.
• SGAP flap: Superior Gluteal Artery perforator flap which takes tissue from the buttock.
• Tissue expansion: A surgical technique to stretch your own healthy tissue and create new skin to provide coverage for a breast implant.
• TRAM flap: Also known as transverse rectus abdominus myocutaneous flap, a surgical technique that uses muscle, fat and skin from your own abdomen to reconstruct the breast.
• Transaxillary incision: An incision made in the underarm area.
• TUG/DUG flap: Also known as transverse upper gracilis/diagonal upper gracilis, two similar types of breast reconstruction procedures that use a patient’s own tissue from the inner thigh to create a new breast after a mastectomy.