How Long Does It Take to Recover from TRAM Flap Surgery?

The patient requires 6 to 12 weeks to regain prior energy levels and resume normal activities.

TRAM stands for Transverse Rectus Abdominis Myocutaneous, a muscle, and tissue of the lower abdomen between the waist and pubic bone. TRAM flap surgery uses the flap (graft) from this skin, fat, and the TRAM muscles forbreast reconstruction.

Advantages of using TRAM flaps are:

• Consistency of the reconstructed breast.
• No occurrence of rejection of foreign material, since the tissue used is from the patient.
• Abdominal rejuvenation.
• Improvement in the reconstructed breast, compared to implants.

TRAM flap surgery is done for the following conditions:

• Patients who have undergone breast removal surgery (mastectomy) as part ofbreast cancer
• Asymmetrical breasts
• Previous failure from implant reconstruction
• Excess lowerabdominal fatand desire for abdominoplasty along with breast reconstruction
• To maximize or preserve abdominal muscle function
• To have the maximum possible blood supply to the TRAM tissues

This surgery should be avoided in the following conditions:

• 心diseases
• Lung diseases, such asemphysemaandCOPD
• History ofblood clots
• Autoimmune diseases that affect the skin, tissues and organs
• Unstable psychiatric disease
• Obesity
• Patients over 70
• Patients reluctant toquit smoking
• Previous multiple abdominal surgeries
• Any contraindication to thedrugs, which prevent coagulation (anticoagulants)
• Patients with inadequate abdomen tissue

Before the procedure

• During the consultation, the patient is informed about the procedure, possible complications, and scarring.
• The patient usually will undergo lab tests, including a complete blood cell count,electrolytes,urinalysis, and blood typing.
• The patient can do abdominal exercises to strengthen their muscles before the surgery.
• The patient is given an enema the day before the surgery.

The procedure involves three stages:

• TRAM flap
• Revisions and乳头reconstruction
• Nipple and areolartattoo

During the procedure

• In the first stage, a flap (mass of tissue used for surgery) is taken from the lower half of the abdomen, shaped in the form of the breast, and used for reconstruction.
• In the next stage, the nipple is reconstructed and revised using tissues from the same breast or the opposite one.
• For the finishing process, the nipple is colorized for the natural look and the symmetry of the breast is enhanced.

After the procedure

• After the surgery, the patient requires hospitalization for three to four days with close observation for the first 24 to 48 hours.
• The patient should not exert any pressure for two months.
• The patient must wear a soft bra and should notsleepon the reconstructed breast.
• The patient requires 6 to 12 weeks to regain prior energy levels and resume normal activities.
• Exacerbation ofback painmay occur.
• Anesthesia effects may still impact the patient 6 to 12 months after the surgery.
• It takes a year for the tissues to heal completely and for thescarsto fade away.

Some of the complications of TRAM flap surgery are:

• Partial or complete tissue breakdown, or death of the flap (5-15%)
• Seroma(fluid collection, usually in the abdominal donor site)
• Hematoma(在胸部或腹部出血)
• Infection
• A noticeable bulge in the abdomen (hernia) (1-5%)
• Abdominal bulge without hernia (5-15%)
• Deep venous thrombosis and/or pulmonary embolus (< 1%)
• Death (< 1%)