Pedicled TRAM Flap Breast Reconstruction Pensacola

Typical Timing/Age Overall health is more important than age. Most (not all) women with breast cancer, at high risk for breast cancer or a history of breast cancer are safe candidates for the procedure.
Problem Absent breast(s) after mastectomy
Deformed breast(s) after lumpectomy
Deformed breast(s) after radiation
Deformed breast(s) after another type of reconstruction
Procedure The skin and fat of your lower abdomen are transferred to your chest to reconstruct your breast(s). The transferred skin and fat is kept alive by leaving it attached to your rectus abdominis (6-pack) muscle. This muscle is cut down low and left attached above. The tissue is then “swung” up to your chest, never being fully disconnected from the body (that is why it is called a “pedicled” flap). The transferred tummy skin, fat and muscle is then shaped into a breast. The abdomen is then closed with mesh and with multiple sutures like a tummy tuck, leaving a horizontal scar across the lower abdomen.
Goal To reconstruct breast(s) without the need for an implant and improve abdominal contour.
Facility Hospital
Preparation Patients cannot be using any nicotine containing substances. Eat lots of protein.
Anesthesia General anesthesia
Recovery
Hospital stay 2-3 days on a regular inpatient floor.
Positioning You may need to keep your hips flexed at all times for 1-2 weeks to help minimize the tension on your abdominal skin incision. This means walking around a little hunched over and sleeping in a recliner or in bed with pillows under your back and your knees. You also need to keep pressure off your chest: so no sleeping on your stomach or side for ~1 month.
Assistance You will need someone to help take care of you after surgery as you will not be able to lift children, heavy items, etc.
Walking You are encouraged to walk around as much as possible to help reduce the risk of DVT and thromboembolism.
Showering After 48 hours you should remove your dressings and take a shower.
Exercise 3 weeks for light exercise. 4 weeks for regular exercise. 6 weeks for abdominal exercises.
Sex Wait 3 weeks because you don’t want to stress your incisions or increase your blood pressure during the early healing period. No one except you can touch your new breast(s) for 8 weeks.
Work 2-4 weeks depending on your type of work.
Swelling Can persist for 3-6 months.
Bruising Usually subsides after 2-3 weeks
Follow-up Appointments 3-5 days after you leave the hospital. Whenever drains are ready to come out. 3 months.
Risks & Complications Partial flap loss. Fat necrosis. Abdominal wall hernia. Abdominal wall bulge. Hematoma, Seroma, Infection, Poor scarring, Dehiscence, Delayed wound healing, Skin necrosis, Asymmetry, Numbness, Thromboembolism, Contour irregularities, Need for revision, Complications related to anesthesia.
Performed by: Dr. Butler, Dr. Leveque
Gulf Coast Plastic Surgery is the only plastic surgery office in the area offering Canfield Vectra 3-D Imaging and Breast Sculptor software.