Tram Flap Surgery

KathyNSW

Am thinking about reconstruction after 8 years and told tram flap is my option .

Has anyone had this reconstruction and what should I expect with recovery etc.

Is it worth it ?

Thankyou for answering.

Meow13

I did DIEP with great success. I don't know about TRAM flap.

nihahi

Kathy.....I have a very successful outcome from a muscle-sparing TRAM. I went through no recon, then a ruptured implant, then a capsular contracture so severe it actually impacted my shoulder joint and bowed my ribs. You can follow the timeline in my bio stats. Many women on the board in reality have had TRAM recons, but describe it as a DIEP. The differences between the two are relatively minor, in the hands of a skilled PS.

In a TRAM, an extremely small piece of muscle surrounding the vessels is transplanted with the flap, in a DIEP, the muscle fibres are separated to gain access to the vessels. The thought that a DIEP doesn't affect muscle is a misconception.

The most important factor is to have a skilled surgeon who will perform the procedure best suited to your individual circumstances.

Mombytheriver

Kathy,

I had BMX with immediate TRAM flap reconstruction in late September. I am very happy with the results and look forward to stage 2 in January. The pain was manageable and I was walking a bit on the day after. My breasts are my own tissue and wiggle and feel natural. The surgery is long and the hardest part for me has been the fatigue afterwards. I am starting to get past it now. I totally agree that the plastic surgeon is the key for this surgery. Not sure where you live - I had my surgery done by a plastic surgeon at the University of Pennsylvania. I highly recommend the whole group there.

Patti

Meow13

My DIEP did not affect muscle. DIEP is different than Tram flap. My recovery was uneventful.

http://stlouisbreastreconstruction.wustl.edu/en/Br...

Meow13

naniahi, Yes I had the DIEP not the Tram. I disagree most women on this site do know what surgery they had.

http://stlouisbreastreconstruction.wustl.edu/en/Br...

nihahi

Meow . ..you're absolutely right . ..I should have typed some, not many. I know when I added my flap recon to my history, the only tram choice in the bco.org database was the pedicle version...a very outdated procedure, so I chose diep, as that was the closest description. I went back and changed the wording when the database changed. Not everyone in the same category did so .

Thanks for posting the excellent article comparing the different flap options. It's a great explanation that shows the benefits of different types, for different reasons .

I'm glad you healed well and uneventfully. ..I did too.

GwennyMD

I had muscle sparring Tram on one side and Diep on the other side. My medical records said Deip because that is what was planned. According to PS the decision to do a Tram vs a Deip is based your anatomy. In my case the muscle tissue on one side was entwined with the blood vessel and and separating them had become too time consuming. To me there is no difference. I could not do sit ups before surgery and cannot do them now.

I think the stomach part of the surgery affects everyone's muscles initially because the PS is cutting everything from one side to the other side and after taking out the appropriate amount of fat they pull your skin very tight and stitch it up. You cannot stand up straight for a couple of weeks.

Recovery is different for each individual. My recovery from the actual surgery was fine however I had just completed 6 months of chemo so I did not have a lot of energy. I only stayed in the hospital for 3 days and I slept in my own bed with a lot of pillows at home. I was able to work part time at home 4 weeks after surgery and returned to the office at 6 weeks.

I love my new breasts and flat tummy.

PNWBCHgirl

I had a pedicle tram -flap in June 2015 . I would do it again if faced with the decision. It is a long recovery and yes you lose muscle and it definitely takes time to regain strength and some may never. About the 3 weeks after surgery you start feeling some what yourself and every day gets better from there. You quickly realize the lowest ab muscle helped you with turning over and lifting your legs when lying on your back. You will need to be careful what you lift because you are more susceptible to hernia's. I am 18 months out and I can swim . hike, ride bikes and most things I enjoy. I do not lift or carry my grand kids around I am very careful they are over 25 pounds. Your body will tell you when your ready. My PS told me what to expect that I would notice range of motion return and most people get it back between 6 months to 2 years. You learn to listen to your body and know what is good for it and not. My best advice I ask lots of questions to your PS and listen to his instructions, plenty of rest is key to a successful Recovery. I am very pleased with my results and look. And the flat tummy is a bonus

KathyNSW

Thankyou so much for your replies. Am grateful and feeling more positive about the op.😊

KarenAus

I had Tram flap done on side and Diep the other due to lack of blood vessels 2 weeks ago. I had done research on the Diep but really know nothing on a Tram. I was wondering how much muscle strength will be lost. I ride dressage and core is so important for that.

KarenAus

nihahi

KarenAus....Of course everyone is different, but likely you'll be fine to get on with your riding.

I was 63 at time of my Tramfree recon. Surgery was in April. I was back hiking with a backpack by June (real hikes...Canadian Rockies), golfing by July, and skiing in early December. As a rider, you likely already have good core muscles and that should help you in your recovery.

KathyNSW

thank you for your replies.

I wonder whether you can have implants after mastectomy and radiation.

Would be less invasive. Not sure about the whole thing but feel like i need to do it for myself.

Thankyou

Kathy