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TRAM stands for Transverse Rectus Abdominis 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 “six-pack” group of muscles, and by using muscle, skin, and fat from this region, Garrett Wirth, MD, MS, FACS can reconstruct the breasts after a mastectomy or lumpectomy.

Am I a Candidate 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. 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
  • Some types of previous abdominal surgery
  • Previous “tummy tuck was “abdominoplasty patients
  • Poor medical condition

How Does TRAM Flap Breast Reconstruction Work?

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 four to eight 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.”

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My wife had a TRAM flap and breast reconstruction in coordination with her double mastectomy 10 years ago with Dr. Wirth. She chose this option, that not a lot of surgeons do due to the complexity of the procedure, because she did not want the maintenance of breast implants. Dr. Wirth's skills, both interpersonal and surgical, are unparalleled, and she was much happier with her body image after his beautiful work than before. My wife and I recommend Dr. Wirth without hesitation nor reservation- he is the best!!


What Happens After TRAM Flap Breast Reconstruction?

Immediately following a TRAM flap breast reconstruction, expect soreness and swelling at all incision and operation sites. Garrett Wirth, MD, MS, FACS 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.

The Results of Your Dreams

Garrett Wirth, MD, MS, FACS has a well-earned reputation for helping women in Newport Beach and the surrounding areas enjoy the bodies they’ve always wanted, performing expert breast reconstruction procedures and offering a number of different techniques for doing so.

During your consultation, you’ll work closely with Dr. Wirth to develop a treatment plan that is tailored to your specific goals, and ensures that you’re able to enjoy the results you know you deserve. Reach out and set up your consultation, and learn how you can love your body and live the life you’ve always wanted, today!

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