Anyone out there with Tram Flap ?

Dhanno

Hi I see lot of women with DIEP but hardly any one with Tram success stories .I met plastic surgeon. He said I might just make a Tram candidate (I have fat but just not in right area of stomach for DIEP ) for one breast .

I think implants work best for me but I am hypothyroid and feel cold all the time.

Implants I read make you feel cold on your chest. I told the PS that this is the only reason implants scare me .

Any one out there with Tram flaps .If you were unhappy about Tram then please do share your experience .If it turned out good then also share please . I know it is not a small surgery but I ready to take my chances .

Runrcrb

dhanno,

Tram flap moves a major muscle, often resulting in other issues. My plastic surgeon said that he considers tram flap close to malpractice in this day and age. I recommend getting a second opinion from another plastic surgeon.

OCDAmy

What area of stomach is your fat?

Dhanno

Most of fat is on the side ways .Central fat is there but not enough .The PS said the new breast will be significantly 2 size smaller than other breast .I am currently C cup so may be A cup .Very tricky .He did not want to commit anything and asked me to get abdominal imaging for blood supply .

Dhanno

Hi Runrcrb Thanks for sharing this with me. No wonder there are not many Tram surgery thread here on this forum .

SpecialK

I don't find my subpectoral implants cold from the inside - I occasionally find the external skin cool to the touch - and the skin has no feeling, but that doesn't make me feel cold.

I do know two members who had TRAM and needed subsequent hernia surgery - neither recommends TRAM to others.

Dhanno

Thanks SpecialK You have given me a very important piece of information .If the implants do not feel cold from inside then I will be happy to go ahead with implants .When I was leaving the PS office the breast care nurse told me not to take decision in haste .I knew she was hinting something

Runrcrb

dhanno,

That nurse is right. While a breast cancer diagnosis is scary and you want if taken care of ASAP, it is rare that a breast cancer diagnosis is a medical emergency. Take time to explore all options and don’t feel bad about getting second opinions. I had two office visits with my breast surgeon and spoke to him several times before the first surgery. I saw two plastic surgeons, one of them twice, before making a final decision. I also met my radiation oncologist prior to the first surgery and my medical oncologist immediately after the sentinel node biopsy. It was 8 weeks from diagnosis to the first surgery.

Take the time to determine the right plan for YOU.

OCDAmy

If you want DIEP, I would also suggest a second opinion. I am almost three weeks post op from DIEP and I'm very happy with the results, warm and soft. I didn't have a ton of belly fat but enough for a small C which is what I was before.

Dhanno

So OCDAmy That is what I wanted a small C . May be the PS is not confident about doing DIEP that is why Tram . Fail to understand why a candidate can be OK for Tram but not fit for DIEP .

Lula73

I’m curious if the PS you saw is a microsurgeon PS. TRAM can be done by just about any PS. That is not the case for DIEP. It requires a microsurgeon. Often PSs who don’t do the surgery you’re asking about will tell you you’re not a candidate for that one (which they are not qualified to do) and then try to sell you on what they can do. Additionally, if you have some tummy fat but not enough they can also look at doing a stacked flap or using your hips/butt instead of your tummy. No reason to go to TRAM.

How could someone be a candidate for TRAM and not for DIEP? DIEP takes skin and fat from your tummy area to rebuild breasts and leaves your abdominal muscles in place. TRAM on the other hand takes your abdominal muscles and builds breasts out of them leaving behind a thin fascia separating your intestines from your skin and subcutaneous fat. That’s why women often have hernia issues and no core strength after TRAM.

Second opinion and even a 3rd or 4th is a good idea. Compare before and after photos of each. If you would not want what you see in those photos for yourself, move on to the next PS on your list. Before doing a consult make sure they are qualified to perform DIEP. The Center for a Restorative Breast Surgery in New Orleans (NOLA) is known for saying yes to DIEP when other PSs say there’s not enough tissue and they get it done successfully for the woman. Most women travel for this surgery so don’t feel like it’s unusual to do so. Here’s a link to their website complete with before and after photos:

www.breastcenter.com

star2017

Dhanno, I have a prepectoral implant and do not feel cold

Dhanno

Thank You star2017 Your reply is very reassuring for me . You cant imagine how important it is for me to know about this aspect of implants .

Moderators

We are looking to interview, and possibly feature in a video, people who have had a revision/corrective breast reconstructive surgery at the Center for Restorative Breast Reconstruction in New Orleans, and are living in the Mid-Atlantic region of the US. If this applies to you, and you are interested, please contact the Mods and let us know a little bit about yourself, including your age, city/town and state, and a few details to what you had completed at the Center.

Thank you!

Linda7

Hi Dhanno,

I had a Free Tram Flap a couple of years ago. I believe the difference between Tram flap and FREE Tram Flap is that they only take out a little bit of muscle. Medically speaking my surgery was a success. I healed fine and it hasn't affected the way my body functions. The only thing I notice is that I have less core strength. For example, I used to be able to hold the plank position and I can no longer do that. But in my regular day to day activities I don't have any problems.

Having said that, on a personal level I wish I wouldn't have gotten this surgery and just kept trying my luck with the implants. I did extensive research on the DIEP flap and most women I communicated with were very happy with the results: "1. it's warm, 2. it feels like a real breast, 3. it feels like it's a part of me, 4. the surgery and recovery is intense but doable" For me personally only 1 and 4 are true.

My first reconstruction was an implant after unilateral mastectomy. I absolutely hated it, with a passion. It looked faker than fake,it felt faker than fake, I could feel my muscles slide over the implant when I moved. My surgeon suggested I try another implant but I wouldn't have it. The implant was a foreign body and I just couldn't accept it inside my body. The other thing was that emotionally I had a really, really hard time losing my breast. I, like many women I'm sure, had had this love affair with my boobs since I got them as a teenager lol. I was just always so content with that part of my body. For me they were perfect. Perfect size, perfect perkiness, you name it. Every swimsuit, every blouse, sweater, outfit I wore was to "show them off". To have it replaced with this stiff, lifeless, unnatural thing was just mentally unacceptable to me and that's why I went for the DIEP/ Free Tram flap. I missed my breast and my old self so badly that I really hoped that I would get something back closer to what I had lost. For me my decision for reconstruction came from how I was dealing with that loss.

What has resulted for me from this surgery vs. the implant that I had is that yes the implant was very uncomfortable (though I never experienced that coldness that people talk about), but my f. tram flap is still not truly comfortable, I've already had one revision and will require one more, to get the shape to look more round. It's not beautiful anyway. I have a rectangular patch from my belly skin on my breast, skin two shades darker. The thing that I really dislike the most is the numbness on my whole abdominal area, the nerves have not regenerated there, even though I stretch and exercise hoping that it'll help. I don't feel as flexible anymore like when I'm dancing. After my first revision I feel my orgasms are a little bit less intense, no kidding, because my tummy just feels so tight. I also lost sensation in my armpit, after mastectomy and immediate reconstruction with implant I was left with sensation in that area. I have a huge scar from one side of my hip to the other, and I have dog ears on my hips, kind of small, but that too will need another revision, that was another part of my body I really liked and now that's messed up. The boob is soft and squishy, but to me it doesn't look nice and round like a breast should and it doesn't feel like a breast anyway.

Now three years later I've accepted the loss of my breast, I just have. I had a great rack and it's gone, it's over. I'm alive and my life is so much more than wearing tight blouses lol. If I had made my decision about reconstruction now, I would have chosen whatever impacted my body as a whole less over aesthetics or feeling like "a real breast", to me nothing will feel or look like my old breast and it's most important to maintain the integrity of the rest of my body. My old implant was hideous lol and uncomfortable, but my f. tram flap isn't all together that comfortable and it's not pretty, so I personally wish I would have given another implant a try before I involved so many other body parts trying to replace the irreplaceable. But it's done, I'm comfortable enough, and I don't want to worry about this anymore.

I don't think your dilemma is similar to my mine, but wanted to share my story for you or anyone out there considering this surgery and taking in different points of view.

Dhanno

Thank You Linda7 .I am 100 % relating to every word of your post .The sense of loss of a body part is shattering .The first thing that comes to your mind is how to replace it with the most natural replacement . That is why I tried to avoid implants in first place

But as days passed my thought process is changing .I am tilting towards implants and try what best options I have with them .

Your honesty has touched my heart and has really helped in reinforcing my decision .I am very grateful to you for making an effort to express your journey .

When I read your post it felt as if I was reading my own mind and what turmoil I am going through right now . Thanks again

sm627

Hi Linda7,

Thank you so much for sharing your journey with all of us. Your experiences and words of wisdom have help me make my decision to let things be and not try to replace something I will never get back again.

Thank You!

Hugs,

Sara