TRAM stands for Transverse Rectus Abdominus Myocutaneous, and refers to the group of muscles located between your xiphoid and/lower ribs and the pubic bone. These muscles are commonly referred to as the “6 pack” group of muscles. By using muscle, skin, and fat from this region, Dr. Garrett A. Wirth can reconstruct the breasts after a mastectomy or lumpectomy. At Wirth Plastic Surgery, we are proud to offer several options for breast reconstruction surgery in Newport Beach, Orange County, and Los Angeles County. We can help you determine which option works best for your needs!
Candidates for TRAM Flap Breast Reconstruction
Any generally healthy woman working to make a full and complete recovery from a mastectomy makes a strong candidate for TRAM flap breast reconstruction. This type of surgery has a relatively high success rate, and gives reconstructed breasts a particularly natural-looking appearance and feel.
The key is to become as informed as possible regarding the requirements for and expected outcomes of such a procedure. If these expectations meet your personal recovery and health goals, then TRAM flap breast reconstruction may be a good option.
This type of reconstructive procedure may not be ideal for women who:
- Don’t have enough spare abdominal tissue to make a flap
- Are smokers
- Have narrow and inflexible blood vessels
- Have multiple abdominal surgical scars (although normal C-section scars usually do not cause a problem)
- Some types of previous abdominal surgery
- Previous “tummy tuck was “abdominoplasty patients
- Morbid obesity
- Poor medical condition
During a consultation here in Orange County, Dr. Wirth and his staff will guide you through the details of TRAM and all other breast reconstruction options, so you can determine if you are a good candidate
How TRAM Flap Breast Reconstruction Works
In a TRAM flap breast reconstruction, Dr. Wirth makes an incision across your lower abdomen. An oval of skin, fat, and muscle is then removed while keeping the blood vessels attached, shaped into a natural-looking breast, and sewn into place at the chest. Along the way, any blood vessels that are damaged or severed are reconnected in the chest using microsurgery.
Because the lower abdomen is the source for TRAM flap graft material, patients also receive a “tummy tuck” as a secondary benefit to the procedure. The entire operation typically takes around 4-8 hours to complete depending on if this is a single side (unilateral) versus both sides (bilateral) procedure and also depending on if this is a “pedicled flap” or “free flap .”
What Happens After TRAM Flap Breast Reconstruction?
Immediately following a TRAM flap breast reconstruction, expect soreness and swelling at all incision and operation sites. Dr. Wirth will properly clean, bandage, and dress all incisions. As with any surgery, it is important to follow all postoperative directions provided by the doctor and staff.
As swelling decreases and incision lines heal, you will begin to see the full outcome of the reconstruction. Keep in mind that although a breast that has been reconstructed using the TRAM flap technique feels natural to others, your sensation in the breast may be seriously affected. The operation also leaves a scar between your hip bones and potential distortion in the belly button.
In some cases, Dr. Wirth may need to rebuild your belly button altogether. Finally, keep in mind that tissue from this region can only be harvested once, so be sure you consider any future needs or operations that may arise when deciding on a TRAM flap breast reconstruction.
To learn more about TRAM flap breast reconstruction in Newport Beach, contact Board Certified plastic surgeon Dr. Garrett A. Wirth at (949) 238-6713.