TRAM flap - Anyone?

KPolasek

Have any of you had the tram flap done?  My breast surgeon has suggested that I have a bi-lateral mastectomy .... let that heal and then do the TRAM .... I am wondering how painful the tram is.  I have read that the mastectomy itself is not too bad .... but what about this reconstruction?  Any wisdom out there?  I will say that I am overweight and my surgeon patted my tummy and said that I would look good after this was done LOL, she is too funny.

K

swimangel72

HI - I'm sorry you're having to go through this - but there is a ton of information here and at other web sites regarding this kind of reconstruction. Check out the threads on the Breast Reconstruction forum. Have you looked into the Diep - where they don't move your stomach muscle, just the fat? Many women have travelled to New Orleans for this surgery. I wanted to stay close to home so I used a plastic surgeon who worked closely with my breast cancer surgeon. Unfortunately he didn't give me a Diep but a muscle-sparing free tram which took a small piece of my muscle.  Your plastic surgeon needs to be a micro-surgoen to do the Diep - many PS's are not so they only suggest the surgery they have experience with. No matter what procedure you do, be sure you find out how MANY your PS has performed and his success rates. My surgery took 7 hours - and yes it was painful.  I thought it would be easier than the 3 c-sections I had, but I was wrong - I didn't take into consideration the fact that I'm much older than I was then (I was 53 at the time of my free-tram). I had a skin-sparing mastectomy followed immediately by the free-tram. It was nice to wake up with a "breast" but it took me many months to get back to normal because I ended up with a MRSA staph infection in my abdominal incision. And my "breast" doesn't really look like a breast or fit into a normal bra, so I'll need more surgery to correct that as well.

This surgery isn't something to take lightly - I feel now I didn't do enough research. I too was a bit overweight - and kept thinking how nice it would be to have the "benefit of a tummy tuck" - but I didn't get a benefit at all. Now I have a very large abdominal hernia that needs more open surgery to repair. I can't do situps and my stomach feels tight - and numb; my new breast also feels numb and heavy. So my advice is to do a ton of research - and be sure to ask you PS to show photos of their patients. Also - ask the PS for the phone numbers of a few patients so you can talk to them. If you're not happy with what you hear, be ready to get a second opinion - and even a third! Good luck with your research - I'm sure other women here will write to you and give you more advice - and probably better outcomes than I experienced.

KPolasek

Thanks for the advice everyone~

Kay

smithlme

Kay,

I, too, agree, do your research. I am that 1% that had a failed TRAM. I did my reading and asked lots of questions. I even have a sister who had the exact same surgery 18 years ago. I now have a larger scar where the flap was removed on my chest, a large, crooked "smiley face" scar on my stomach, a numb chest, up the middle of my stomach is numb, I have dog ears on the ends of my stomach scar and numbness along the large scar. Was it worth it for the added tummy tuck? Heck NO!

I went in to the surgery knowing there was a chance it would fail. I was hoping I would beat the odds, but it just wasn't meant to be. It was a long heal that ended in having an even flatter chest..

Linda

TammyLou

Well, that sucks.

I am so sorry.

Tammy Lou

kimbri

I had a bilateral mastectomy with Tram Flap Reconstruction 2/08.  It was a lot more painful than I thought it would be.  One of the hardest things to deal with were the drains.  I also couldn't walk upright for awhile.  I also couldn't lie flat down so I had to sleep on the couch in a sitting position.  Once the drains came out it wasn't as bad.  My PS used my c-section scar to cut along so it was low.  I had enough fat to get a decent B cup.  My breasts look really good under a shirt and I don't ever need to wear a bra again. I am having the nipple/areola reconstruction next week.  At the same time she will take care of the "dog ears" on the end of my abdominal incision.  Also a little lipo to even things out.  I don't regret getting the Tram but it does feel a little weird having my abdominal muscles now pulled up to my breasts.  I can no longer do sit-ups.  But I look good and I'm alive.  I'm also a TN and finished chemo 9/08. 

nancyluvspink

I had a bilateral mastectomy with immediate tram reconstruction in June 08.  I am now about 5 months out.  The surgery was long, (13 hours), but it went fast for me, personally.  I am very happy with the results to date.  Yes, the drains were really a pain and gross.  One of the best days post-op was getting them out!  As for pain, I had more pain in my chest area than anywhere else.  It just felt soooooo tight.  But, that has passed now.  Still have numbness.  The tummy tuck was a real bonus.  I have no complaints, I had been through a hysterectomy six months previous and I feel the pain and discomfort was worse in the belly area, than the tram flap reconstruction.  I have an appt. in Dec. with my PS to talk about nipples, so that I can finish the picture.  At first, I didn't want nipples, as months have passed by, I have changed my mind.  Hope this helps and good luck.

pinoideae

Pedicle tram June 2008.  Very very painful for about 7 days, and then started to get much better.  Consult with your ps about reconstruction and definitely check out http://www.breastcancer.org/treatment/surgery/reconstruction/why/index.jsp

Edited to add:  Pedicle tram patients have quite a few restictions after surgery for approximately 8 + weeks if you are to achieve positive long term results.  There is risks as with any surgery that you should also research.