Breast reconstruction after mastectomy consists of either breast implants or flap surgery. Flap surgery is the movement of your own tissue on your body to reconstruct the breast. A TRAM flap is the procedure which takes the abdominal tissue from the lower stomach, and moves it up to the breast. This skin and fat is then shaped into a breast. The scar that results on the abdomen is similar to the abdominoplasty or "tummy tuck" scar. This procedure can dramatically restore both the shape of a woman's body and her self-image following cancer surgery.
A TRAM flap can be performed either at the time of mastectomy or at a later time (after chemotherapy has been completed). Because the TRAM is your own tissue, it can be more easily shaped, and is soft, warm to the touch, and if you gain or lose weight, the two breasts remain more symmetrical. Most plastic surgeons consider this the best (but most challenging) form of breast reconstruction in the appropriate patient.
I trained with Dr. Carl Hartrampf, the originator of the TRAM flap, and Dr. John Bostwick, one of the country's foremost experts in this type of specialized surgery.
Surgery: TRAM flap requires a 4 day stay in the hospital.
Healing time: Drains are used in the abdomen and the breast. The last drain is usually removed in one week. Walking is started immediately, and by 2 weeks, you are back to a semi-normal routine. No heavy lifting or abdominal work for 6 weeks much like a "tummy tuck". Most people return to work in 4-6 weeks.
Pain level: Most people take pain medications for 1 week, then switch to Tylenol®. Rank=6 Pain information
Risks: Numbness of the breast and abdomen. Abdominal weakness will improve with time and exercise (most patients report full strength at 1 year). Scars around the breast and abdomen. Fat necrosis or firm spots in the breast can occur. Other risks. Risk information
Costs: Because this is an insurance covered procedure, the cost is determined by the insurance company. If Dr. Prescott does not accept your insurance, you can pay directly for this surgery. Cost information