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The Transverse Rectus Abdominal Muscle flap, also known as the TRAM flap breast reconstruction is a process where a breast is reconstructed at the site of the mastectomy using the abdominal tissue from the patient herself. When a person undergoes mastectomy due to cancer or any other illness, normally the whole breast is surgically removed leaving only a flat surface. The patient has physical and psychological scars due to this and wishes to go in for breast reconstruction to regain the lost self-confidence and also for aesthetic beauty.
Reconstructive surgery can reconstruct the breast in several steps. The whole procedure takes at least six months, as it is quite an intricate and difficult one. Not only has the breast mound to be recreated but also the nipple, and care has to be taken to provide a symmetrical breast with the healthy one. In case there is any difference, the other breast may also have to undergo surgery to come at par with the reconstructed one. As it is a lengthy process involving several procedures, the patient has to give it a deep thought, find a suitable surgeon who can give her what she wants and then be prepared for a long and tedious and a bit painful experience.
There is no gain without pain and in a breast reconstruction it holds true. There are several procedures to reconstruct a breast and the most popular one is the implant technique where a tissue expander expands the tissue in about six weeks, and then the implant gives the breast its shape. Another method is the TRAM flap breast reconstruction. In this method an abdominal flap is used for the reconstruction. The tissue between the umbilicus and the pubis is surgically removed and grafted on the breast area. The whole rectus muscle may be used for this procedure. Sometimes only a small part of the muscle is removed which will retain the abdominal strength after surgery.
This TRAM flap method requires an advance microsurgical technique. There is enough tissue to reconstruct even a large breast and it has the added advantage of an abdominoplasty where the fat from the abdomen is removed or the muscles are tightened giving it an improved look. Though the TRAM flap procedure may weaken the abdominal muscles, the patients generally tolerate it and pose no problem. Also this muscle weakness can be avoided by placing a piece of surgical mesh over the operated area and sutured in place. The tissues are sutured along with the blood vessels to the breast area and they will take root within six weeks. After that the nipple needs be reconstructed. The patients should refrain from heavy activity, sexual activity and take care of both the operated sites. There may be a bit of pain, some leakage, tenderness, all of which the surgeon can cure. |
