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TRAM Flap

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TRAM (Transverse Rectus Abdominis Muscle) Flap

In a TRAM Flap procedure, tissue is taken from the lower abdominal area and used to help shape the breast. Skin, fat, blood vessels and at least one muscle from the abdomen are moved from the abdomen to the chest.

There are two types of TRAM flap breast reconstruction: Pedicle Flap and Free Flap.

Pedicle Flap

In a Pedicle Flap procedure, skin, fat and muscle are removed from your lower abdominal area and used to reconstruct your breast. The muscle, which carries the blood vessels from your lower abdomen area, remains attached to the original blood supply and is tunneled under your skin to the breast region.

Click the images below to enlarge

Preoperative markings

Flap transfer during surgery

Postoperative appearance

In addition to the potential advantages and disadvantages listed on the Autologous Breast Reconstruction page, other potential advantages and disadvantages of TRAM Pedicle Flap are also outlined here.

Potential Advantages | Potential Disadvantages
  • Less time needed in surgery versus some other autologous reconstructions, i.e. DIEP and gluteal
  • Less risk of your body rejecting the tissue and less risk of scar tissue forming
  • Results in tightening of the lower abdomen skin – similar to a tummy tuck
  • May decrease the strength of the abdomen
  • Risk of an abdominal hernia occurring
  • May affect mobility and range of motion

Free Flap

In a Free Flap procedure, skin, fat and muscle are removed from the lower abdominal area and moved up to the chest in order to reconstruct your breast. Blood vessels attached to these tissues are also removed from your lower abdomen area and are then reattached to the existing blood vessels in your chest.

Click the images below to enlarge

Preoperative markings

Flap transfer during surgery

Postoperative appearance

In addition to the potential advantages and disadvantages listed on the Autologous Breast Reconstruction page, other potential advantages and disadvantages of TRAM Free Flap are also outlined here.

Potential Advantages | Potential Disadvantages
  • Less risk of your body rejecting the tissue and less risk of scar tissue forming
  • Results in tightening of the lower abdomen skin - similar to a tummy tuck
  • May decrease the strength of the abdomen
  • Risk of an abdominal hernia occurring
  • Microsurgery to connect blood vessels requires extra time in surgery
  • Complications associated with microsurgery may result in tissue not surviving when moved to the breast
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