Breast Reconstruction- AUTOGENOUS RECONSTRUCTION – TRAM with Dr. Kind
AUTOGENOUS RECONSTRUCTION – TRAM
Autogenous means "one’s own". In autogenous reconstruction the patient’s tissue is used to create a breast. When tissue (not just skin) is moved from one part of the body to another it is called a "flap". There are several different flaps that are used for breast reconstruction. The most commonly performed is a "TRAM" flap. "TRAM" is an acronym for "transverse rectus abdominis myocutaneous". This refers to the transverse (or sideways) orientation of the skin and fat taken from the lower abdomen, supplied by blood vessels that come through the rectus abdominis muscle (see figure 1). A "pedicled" TRAM flap is when the skin and fat of the lower abdomen is elevated with the underlying rectus abdominis muscle, and transferred to the chest. The skin and fat are supplied by the "pedicle" of muscle, which carries and protects the blood vessels.
Figure 1
The TRAM flap has many advantages. The use of the skin and fat of the lower abdomen is similar to an abdominoplasty ("tummy tuck"). Most patients are pleased to have this tissue removed. A major benefit of the TRAM, and all types of autogenous breast reconstruction, is that such reconstruction avoids the disadvantages of implant reconstruction. Breasts that are reconstructed with the patient’s own tissues usually look and feel more natural, and act more like a normal breast over time.
The main disadvantages of the TRAM flap is that compared to implant reconstruction it is a longer operation, usually requiring a longer hospital stay. In addition the TRAM flap requires the sacrifice of part or all of the rectus abdominis muscle. Most patients have minimal side effects from the loss of this muscle, although occasionally it can result in abdominal weakness, bulging, or (rarely) hernia.
This plastic surgeon in San Francisco serving the Bay Area offers all aspects of plastic surgery including tummy tucks, facelifts, nose surgery, breast reduction and more. Contact Dr Kind at 415-565-6884 or email us. View plastic surgery photos from this San Francisco plastic surgeon.