who is a candidate?

• If you have loss of breast tissue and skin following mastectomy -- one or both sides.
  

• If you have loss of breast tissue only following subcutaneous mastectomy.
  
  
• If you have a desire for larger breasts (uncommon).

intended results:

• Reconstruction of a missing breast(s) or replacement of breast tissue.

procedure description:

• A flap of lower abdominal wall fat, muscle (and usually skin), is transferred to the area of missing breast tissue with its own blood supply. In a standard TRAM Flap, the blood supply is within the rectus muscle(s) which is left attached at the lower edge of the rib cage. In a Free TRAM, the blood vessels are reconnected to vessels in the axilla. In a Turbocharged TRAM, the muscle is left attached superiorly, but the inferior vessels are connected in the axilla creating a double blood supply.

• The abdominal donor site is closed as in a Tummy Tuck, leaving a horizontal scar and a tighter abdomen.
  
  
• An attempt is made to create a "normal" breast mound and shape at the first operation, but subsequent smaller procedures are frequently necessary.
  
  
• Nipple/areolar reconstruction is performed at a later date and is elective.

recuperation and healing :

• Ambulation will begin the day after surgery and be reasonably comfortable within 10-14 days.


• Complete recovery usually takes about 6 weeks.


• The abdominal donor site causes the most discomfort during healing.

other options:

• Additional procedures that will enhance the result are enlargement, lifting, or reduction of the opposite breast, and nipple/areolar reconstruction.

insurance guidelines:

• Almost always covered by insurance.

note:

• The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.