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Pedicled TRAM Flap Breast ReconstructionTypical 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 are 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 the 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. 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 the house 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

It can persist for 3-6 months.

Bruising

Usually subsides after 2-3 weeks.

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, Dr. Patterson

Gulf Coast Plastic Surgery

543-A Fontaine Street

Pensacola, FL 32503

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The Skin Care Center at Gulf Coast Plastic Surgery

4707 N. Davis Highway

Pensacola, FL 32561

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