TRAM flap breast reconstruction utilizes the tissue of the patient for creating a natural looking and soft breast mound. This grafted tissue is generally taken from a woman’s abdomen which is tunneled underneath the skin in the breast region having the source of blood uninterrupted. This option may lead to the sacrifice of some abdominal strength. It is sad that a lot of women undergo breast cancer without appropriate information about the options of a breast reconstruction.
Women should understand the available options even if they decide against reconstruction of the breast. It allows for an increased sense of control as well as wellness in patients suffering from breast cancer.
Breast reconstructive methods are improving every day, thus offering women an expanding choice of options. TRAM flap is a process of tissue flap which uses fat, skin and muscle from the abdomen to form a new mound of breast following a mastectomy.
The process of TRAM flap breast reconstruction derives from the muscle known as transverse rectus abdominus in the stomach. The TRAM flap can be done in 2 ways: like a detached or free flap of tissue and like an attached or tunneled pedicle.
Process of TRAM flap breast reconstruction
The reconstructed breast does not look or feel like a natural breast; women need further surgery for the creation of an areola and nipple. In the process, the fat, muscle and skin is moved from the tummy to the chest region for creating a mound. In the absence of adequate tissue, a tiny implant may be positioned to fill the new mass of breast. The process of reconstruction follows 2 options:
- Pedicle Flap: This process of TRAM flap breast reconstruction does not necessitate the cutting of the skin flap, blood vessels, fat and muscles from their location in the abdomen. The pedicle flap is moved using a channel under the skin right up to the chest region.
- Free Flap: This process requires your surgeon to make an incision in the skin, blood vessels, fat and muscle from the location in the abdomen. The section is relocated in the chest region and reattached to the supply of your blood vessels with the help of microsurgery. The process is identical to the DIEP flap process, and takes more of time than the pedicle flap reconstruction. However, for a lot of physicians, this method helps create a natural shape of the breast.
The breast which is reconstructed with TRAM flap feels like a normal breast usually to people who touch you. It is soft and warm as it has optimum circulation and sufficient amount of fat to sway and drape as a real breast. As fat and abdominal muscles are inserted into the new breast in TRAM flap breast reconstruction, you also gain by having a tucked in tummy, and hence a flat abdomen.
Remember that the patient is given general anesthesia or intravenous sedation during the procedure. Those who undergo a mastectomy along with reconstruction simultaneously will have the breast eliminated first to determine the skin which is safe for keeping.