Free-TRAM Flap (Free-Transverse Rectus Abdominus Myocutaneous Flap)
A Free-TRAM flap is a microsurgical breast reconstruction where skin, fat, muscle and the associated blood vessels that keep it alive are transplanted to the chest wall from the lower abdomen. Blood vessels of the flap are connected to either blood vessels in the chest wall or under the arm in the axilla using a operating room microscope. A free-TRAM flap can be performed in a 4-hour general anesthetic in the setting of a 4-day hospital stay with a focus on flap monitoring. It is a moderately painful operation, less than a TRAM but more than a DIEP flap. Blood thinners are administered to prevent deep venous thromboses or pulmonary emboli.
Free-TRAM flap breast reconstruction has been associated with weakness of the abdominal wall, abdominal wall buldging, hernias and back pain.
Nipple and areolar reconstructions are performed as staged procedures (see below).
Dr. Marga prefers DIEP flaps over Free-TRAM flaps and would be pleased to address the benefits of DIEP flap breast reconstruction with you.