Tissue Flaps: A Natural Approach to Breast Reconstruction

Since its founding in 1968, Atlanta Plastic Surgery, P.C. has come to be recognized throughout the medical community as one of the Southeast’s premier cosmetic and reconstructive plastic surgery centers.  From the very beginning, we have been committed to pioneering innovations in the field of breast reconstruction for women who have undergone mastectomy for the treatment of breast cancer, a commitment reinforced each year with our participation in the annual Atlanta Breast Surgery Symposium as well as in our contribution to the development of the world-renowned TRAM flap breast reconstruction procedure.

breast-reconstruction-newnan-gaThe TRAM flap procedure was developed over thirty years ago by Atlanta Plastic Surgery co-founder Dr. Carl Hartrampf, Jr., and is still one of the most preferred techniques for natural tissue breast reconstruction used today.  TRAM, or transverse rectus abdominus myocutaneous, surgery uses a portion of a woman’s own abdominal fat, muscle, and skin to reconstruct the breast instead of relying on an artificial breast implant.  The general, or pedicled, form of the procedure is performed by moving the tissue flap through the inside of the body, behind the upper abdominal skin to the chest, while keeping the connecting blood vessels intact.  Because the tissue’s original blood supply is preserved, the reconstructed breast heals and grows just like any natural part of the body.  A somewhat less invasive approach involves a modified “free” TRAM flap procedure, where abdominal tissue from the same location is completely detached from the abdominal wall and transported externally.  In this case the blood flow to the reconstructed breast is maintained by reattaching the tissue to arteries and veins under the arm and behind the breastbone through microsurgical techniques.

While many patients see the removal of tissue from the abdomen as an added benefit of their surgery, a sort of bonus tummy tuck that can create a more slender and contoured midsection, the loss of abdominal muscle can also potentially weaken the abdominal wall, which could result in a hernia.  An alternative technique known as the deep inferior epigastric perforator (DIEP) flap method utilizes the same process as the TRAM, but only harvests a patient’s skin and fat, without the muscle and accompanying blood vessels, avoiding abdominal weakness.  While some believe that the DIEP flap method can create a more naturally textured breast, the procedure uses tissue and skin in much the same way as the other two techniques.  Many reconstructive surgeons favor TRAM procedures because they provide increased blood supply, have a significantly reduced operative time, and still achieve similar results in abdominal wall function.

It is extremely important, when considering breast reconstruction surgery, to discuss with your plastic surgeon important details about your lifestyle, health history, and desired results in order to determine which approach is ultimately best for you.  If you are interested in learning more about Atlantic Plastic Surgery, P.C. or the plastic surgery procedures our plastic surgeons perform, contact us at one of our Atlanta, Alpharetta, Cumming, or Newnan offices.  Additionally, we provide a variety of options for financing, including CareCreditSM, in order to assist you.  Please contact Atlanta Plastic Surgery with any questions you may have concerning the financial planning of your procedure and don’t forget to follow us on Facebook, Twitter, and Google+ for the latest news.