Pedicled TRAM Flap

Pedicled TRAM (transverse rectus abdominis myocutaneous) flap breast reconstruction uses abdominal skin, fat and muscle to reconstruct one or both breasts. Most of this same tissue would be removed and discarded during a "tummy tuck" procedure.

The pedicled TRAM flap is an excellent option in many patients when microvascular surgery options such as the DIEP flapSIEA flap or muscle-sparing free TRAM flap are not reasonable or recommended. However, these more specialized techniques – in which surgeons use microscopes and other special tools to connect blood vessels and maintain blood flow in the tranferred tissue – typically lead to faster recovery times and improved long-term function.

Pedicled TRAM flap reconstruction is performed under general anesthesia and takes three to five hours for one breast and four to six hours for both breasts. Patients are hospitalized for four to eight days and can return to work in six to eight weeks.

Common side effects include bruising and swelling. Several temporary drain tubes remain in place after surgery. The pedicled TRAM flap is associated with a higher degree of muscle weakness and bulge than any of the microvascular breast reconstruction options. Delayed wound healing occasionally occurs. Partial flap failure is infrequent.

Listen to a physician explain differences between the DIEP flap and TRAM flaps.