TRAM Flap

What is a TRAM Flap? – Orange County | Newport

The most common procedure for autogenous tissue reconstruction is the pedicled transverse rectus abdominus myocutaneous (TRAM) flap. In this approach, Dr. Seify uses the entire rectus abdominus muscle to pull the lower abdominal skin and fat up to the chest wall. He then creates a breast shape using this tissue. To transfer the flap up to the chest, the muscle is tunneled beneath the upper abdominal skin. Because the patient’s own body tissue is used, the result is a very natural breast reconstruction. Also many patients benefit from a flatter looking abdomen. The incision and scar on the abdomen is low and will extend from hip to hip. The tram flap can be utilized for reconstruction of breast either bilaterally or unilaterally. When patients are having unilateral reconstruction, the Tram flap can possibly offer a more aesthetically pleasing result and better symmetry thin utilizing an implant.

The Tram flap is possible because of the superior epigastric vessels, which are considered to be secondary blood supply for the lower abdominal wall skin. Some patients are not candidates for this type of reconstruction due to the fact that there are limitations in the flap blood supply. For example smokers, diabetics, and patients who are obese are generally considered to have relative contraindications to having a pedicled TRAM flap breast reconstruction.

The primary advantage to the Tram flap is the natural looking and feeling breast, the main disadvantages are related to the abdominal wall donor site. These include are not limited to abdominal wall weakness, bulging, and hernia. To minimize the development of a hernia, Dr. Seify may use a synthetic mesh when creating closure of the abdomen.

The Tram flap surgery is much more invasive than implant reconstruction. The surgery will typically take Dr. Seify approximately 4 to 5 hours. For bilateral reconstruction, it could be approximately 5 to 7 hours. The hospital stay is typically 3 to 5 days. Patients will experience abdominal pain and tightness for several weeks and it could take several months to return to the full range of activities.

Secondary procedures following tram flap reconstruction can be performed in approximately 3 months. However, if chemotherapy is indicated, additional surgery must be postponed until the completion of treatment. Once the patient has been medically cleared they can have revisions to the breast and abdomen performed and the nipple areola can be created. These procedures are typically performed on an outpatient basis and have rapid recovery.

Ideal candidate for TRAM flap reconstruction include Bruno not limited to:

  • patients who desire autogeneous reconstruction
  • patients who do not want or are not a candidate for implant reconstruction
  • patients who have substantial lower abdominal wall tissue to create one or both breasts
  • patients who have not had prior abdominal surgery
  • patients who previously had chest wall radiation
  • patients who have experienced failed implant reconstruction
  • patients who are having immediate reconstruction during skin-sparing mastectomy
  • patients who are having delayed reconstruction after prior mastectomy

Patients  are not  ideal candidates for TRAM flap reconstruction if:

  • patients  do not have enough lower abdominal tissue to create the flaps
  •  patients have a large overhanging pannus of abdominal skin and fat
  • patients have a BMI of 30 or above
  • patients have diabetes
  • patients who are a smoker sor quit smoking only recently
  • patients have had previous abdominal surgeries such as abdominoplasty
  • patients who cannot tolerate anesthesia for long periods
  • patients who do not want to have a lower abdominal scar

See more procedures and treatments by Newport Beach Plastic Surgeon, Dr. Hisham Seify

What is a TRAM Flap? – Orange County | Newport

The most common procedure for autogenous tissue reconstruction is the pedicled transverse rectus abdominus myocutaneous (TRAM) flap. In this approach, Dr. Seify uses the entire rectus abdominus muscle to pull the lower abdominal skin and fat up to the chest wall. He then creates a breast shape using this tissue. To transfer the flap up to the chest, the muscle is tunneled beneath the upper abdominal skin. Because the patient’s own body tissue is used, the result is a very natural breast reconstruction. Also many patients benefit from a flatter looking abdomen. The incision and scar on the abdomen is low and will extend from hip to hip. The tram flap can be utilized for reconstruction of breast either bilaterally or unilaterally. When patients are having unilateral reconstruction, the Tram flap can possibly offer a more aesthetically pleasing result and better symmetry thin utilizing an implant.

The Tram flap is possible because of the superior epigastric vessels, which are considered to be secondary blood supply for the lower abdominal wall skin. Some patients are not candidates for this type of reconstruction due to the fact that there are limitations in the flap blood supply. For example smokers, diabetics, and patients who are obese are generally considered to have relative contraindications to having a pedicled TRAM flap breast reconstruction.

The primary advantage to the Tram flap is the natural looking and feeling breast, the main disadvantages are related to the abdominal wall donor site. These include are not limited to abdominal wall weakness, bulging, and hernia. To minimize the development of a hernia, Dr. Seify may use a synthetic mesh when creating closure of the abdomen.

The Tram flap surgery is much more invasive than implant reconstruction. The surgery will typically take Dr. Seify approximately 4 to 5 hours. For bilateral reconstruction, it could be approximately 5 to 7 hours. The hospital stay is typically 3 to 5 days. Patients will experience abdominal pain and tightness for several weeks and it could take several months to return to the full range of activities.

Secondary procedures following tram flap reconstruction can be performed in approximately 3 months. However, if chemotherapy is indicated, additional surgery must be postponed until the completion of treatment. Once the patient has been medically cleared they can have revisions to the breast and abdomen performed and the nipple areola can be created. These procedures are typically performed on an outpatient basis and have rapid recovery.

Ideal candidate for TRAM flap reconstruction include Bruno not limited to:

Patients  are not  ideal candidates for TRAM flap reconstruction if:

See more procedures and treatments by Newport Beach Plastic Surgeon, Dr. Hisham Seify

Liposuction | Body Contouring| Tumescent Liposuction| Liposuction Surgery| Fat Removal| Vaser Liposuction| Liposuction Cost| Cosmetic Surgery| Laser Liposuction| Liposuction Laser| Plastic Surgery| Liposculpture| Liposuction Procedures| Lipoplasty | Mini Tummy Tuck| Abdominoplasty| Lower Abdomen| Mini Tummy Tuck Consultation| Cosmetic Surgery| C-section Scar Revision| Mini Tummy Tuck Cost| Body Contouring| Umbilical Hernia Repair| Mini Tummy Tuck Candidate| Excess Skin Removal| Mini Tummy Tuck Results| Muscle Tightening | Post Bariartic Surgery| Stretch Mark Removal| Reconstruction Surgery| Body Transformation| Post Bariatric Reconstruction Surgery| Cosmetic Surgery| Body Lift| Combination Procedures| Arm Lift| Restoring Pre-Pregnancy Figure | Smart Lipo | SLaser Liposuction | SLaser-Assisted Liposuction | SSmart Lipo Procedure | SBody Contouring | STargeted Fat Reduction | SSmart Lipo Surgery | SFat Removal | SSkin Tightening | SSmart Lipo Cost | SMinimally Invasive Procedure | SSmart Liposuction | SPrecision Body Sculpting | Tummy Tuck | Tummy Tuck Surgery | Abdominoplasty | Tummy Tuck Cost | Breast Augmentation | Cosmetic Surgery | Breast Enhancement Surgery | Breast Enlargement | Breast Augmentation Procedure | Implant Options | Breast Augmentation Cost | Breast Enhancement | Breast Implants | Explant Surgery | Implant Deflation | Breast Implants Removal | Breast Implant Extraction | Implant Rupture | Breast Implant Removal Surgery | Implant Removal Procedure | Breast Explantation | Capsulectomy | Breast Implants Removal Surgery | Breast Revision Surgery | Breast Lift | Sagging Breasts | Breast Reshaping | Breast Lift Surgery | Breast Ptosis | Breast Positioning | Breast Lift Cost | Nipple Repositioning | Breast Lift Procedures | Breast Firming | Mastopexy | Breast Contouring | Breast Reconstruction | Mastectomy | Nipple Reconstruction | Breast Reconstruction Surgery | Tissue Expander | Breast Reconstruction Treatment | Implant Reconstruction | Breast Reconstruction Cost | Autologous Reconstruction | Breast Cancer Reconstruction | Flap Reconstruction | Breast Reduction | Reduction Mammaplasty | Breast Reduction Surgery | Large Breast Reduction | Breast Reduction Procedure | Breast Hypertrophy | Breast Reduction Surgery Cost | Breast Size Reduction | Breast Reduction Price | Breast Revision | Implant Replacement | Breast Revision Surgery | Capsular Contracture | Breast Revision Surgery Cost | Implant Malposition | Breast Implant Revision | Implant Rupture | Corrective Breast Surgery | Gynecomastia | Male Breast Reduction | Male Breast Reduction Surgery | Male Breast Reduction Cost | Enlarged Male Breasts | Face Lift | Facial Rejuvenation | Deep Plane Lift | Face Lift Surgery | Facial Aging | Mini Face Lift | Face Lift Procedures | Sagging Skin | Mid Face Lift | Facelift Cost | Wrinkle Reduction | Rhytidectomy | Facelift Techniques | Brow Lift | Brow Ptosis | Brow Lift Techniques | Brow Lift Surgery | Sagging Eyebrows | Endoscopic Brow Lift | Brow Lift Procedures | Forehead Wrinkles | Direct Brow Lift | Brow Lift Cost | Eyebrow Positioning | Temporal Brow Lift | Eyebrow Lift Surgery | Upper Face Rejuvenation | Neck Lift | Neck Contouring | Neck Lift Surgery | Neck Rejuvenation | Neck Lift Surgery Cost | Neck Lift Surgery Procedures | Cervicoplasty | Chin Implants | Plastic surgery | Facial implants | Chin implant types | Chin Implant Surgery | Cosmetic procedure | Chin reshaping | Chin implant benefits | Chin Implant Cost | Chin augmentation | Facial symmetry | Chin implant consultation | Chin Implant Procedure | Facial harmony | Chin augmentation surgery | Chin implant candidates | Facial contouring | Jawline enhancement | Facial aesthetics | Ear Surgery | Ear pinning | Earlobe repair | Otoplasty Surgery | Cosmetic surgery | Ear surgery procedure | Otoplasty Procedure | Ear correction | Ear surgery benefits | Ear Surgery Cost | Prominent ears | Ear surgery risks | Ear Surgery Price | Ear reshaping | Ear surgery recovery | Eyelid Surgery | Cosmetic surgery | Eyelid surgery procedure | Eyelid Surgery Cost | Eyelid rejuvenation | Eyelid surgery benefits | Blepharoplasty | Eyelid lift | Eyelid surgery risks | Upper Eyelid Surgery | Upper eyelid surgery | Lower Eyelid Surgery | Lower eyelid surgery | Anti-aging Treatment | Holistic wellness | Anti-aging Treatment Cost | Preventive healthcare | Anti-aging | Regenerative medicine | Integrative medicine | Longevity | Age management | Anti-aging consultations | Hair Transplantation | Hair Transplantation Procedure | Hair Transplantation Cost | Hair transplant consultation | Hair transplant before and after
NewportPlastic