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Transverse Rectus Abdominus Muscle (TRAM) Flap Surgery

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Transverse Rectus Abdominus Muscle (TRAM) Flap Surgery  

What is transverse rectus abdominus muscle flap surgery?

Many women breast cancer patients undergoing partial or complete mastectomy desire restoration of the shape and size of their affected breast to help them feel physically and emotionally whole, balanced, feminine, attractive, and well.

Tissue flap surgery of the breast is one of the options for reconstructive surgery of the breast after partial or complete mastectomy. A type of tissue flap surgery of the breast is called transverse rectus abdominus muscle (TRAM) flap (also termed rectus abdominus flap) surgery.[1]

The TRAM flap surgery involves overlaying skin, fat, the rectus abdominal muscle, and blood vessels from the lower abdomen to the affected area of the chest.[1-3] In the TRAM flap procedure, a breast mound is created. In most TRAM flap surgeries, an implant is not used.

Advantages of TRAM flap reconstruction are:[1, 2]

• A natural-looking breast
• Flattening of the lower abdomen, as the procedure results in a "tummy tuck"
• Avoidance of side effects due to synthetic materials

Disadvantages of TRAM flap reconstruction are:[2,3]

• A more complex surgical procedure
• Muscle weakness in the abdominal area from which the flap was taken
• Scar in the abdominal area from which the flap was taken
• After recovery, little sensation in the affected breast

Guidance on choices and support for breast cancer patients:

If you are a breast cancer patient who is going to undergo breast surgery, be informed about your choices about types of oncology surgery and timing and types of reconstructive surgery. In advance, discuss all your options with your healthcare team (e.g., your surgical oncologist, plastic surgeon, medical oncologist, radiation oncologist, oncology nurse, and integrative medical physician) and a breast cancer patient support group. Finding out your options, talking with other women who have faced similar issues, and taking enough time to make the decision will help you determine whether reconstructive breast surgery is right for you.


1. American Cancer Society. Glossary.
2. B. Joseph. Complementary and conventional approaches to healing. In "My Healing From Breast Cancer." 1996. New Canaan, CT: Keats Publishing.
3. FDA. Breast Implant Consumer Handbook. 2004. Accessed at www.fda.gov/cdrh/breastimplants.

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