TRAM/ Free TRAM Breast Reconstruction at Atlanta Plastic Surgery, P.C.

Performed at our Atlanta, Alpharetta and Cumming, GA locations.

Our own Atlanta Plastic Surgery, P.C. co-founder Dr. Carl Hartrampf is world-renowned in the field of reconstructive plastic surgery for his invention and implementation of the original TRAM flap breast reconstruction procedure. TRAM, or transverse rectus abdominus myocutaneous, surgery utilizes a portion of a woman’s abdominal fat, muscle, and skin to reconstruct a breast that has been removed or affected by a cancer-eliminating mastectomy. Because the TRAM method-constructed breast maintains its own blood supply and utilizes a patient’s own tissue, it tends to produce a more symmetrical, natural looking breast than those reconstructed using a saline or silicone breast implant that has been placed beneath the skin.

There are two versions of TRAM breast reconstruction surgery performed at Atlanta Plastic Surgery, the Pedicled TRAM and the Free TRAM procedures. During a pedicled TRAM flap the connection to blood vessels within the abdominal tissue is maintained as it is shifted subcutaneously to its new position. During a free TRAM procedure, the donor tissue is completed separated from the blood supply before being repositioned as a new breast.

Frequently Asked Questions about TRAM Flap Breast Reconstruction

What is a TRAM flap and how does it work?
TRAM flap stands for the transverse rectus abdominus myocutaneous flap method of breast reconstruction. The TRAM flap operation entails the transferring of fat, skin, and muscle from the lower abdominal wall to the chest to reconstruct the breast. Blood vessels are not severed, so blood is supplied to the transferred fat and skin through a small portion of the rectus abdominus muscle.

What is the difference between a pedicled TRAM flap and a free TRAM flap?
In a pedicled TRAM flap, the tissue is passed inside the body behind the upper abdominal skin to the chest where the breast is then reconstructed. In a free TRAM flap procedure, the tissue is completely detached from the abdominal wall. Subsequently, the detached tissue is reconnected to an artery in the chest to re-establish blood supply, and is then shaped into a new breast.

What are the risks to the breast with TRAM flap surgery?
Although complications in breast surgery are generally rare, some women who have undergone a TRAM flap procedure do complain of breast asymmetry, which occurs most frequently when only one breast has required reconstruction. However, as with any type of surgery, there are other risks such as fatty tissue firmness, partial flap loss, or in some cases, complete flap loss. All of these issues can be usually be corrected with breast revision techniques.

What are the risks to the abdomen with a TRAM flap surgery?
Although rare, there is a possibility that the removal of muscle from the abdominal area with TRAM flap surgery may result in abdominal weakness, which could potentially result in a hernia. In most cases, however, patients are still able to maintain normal daily routines and physical activities.

What are the benefits of TRAM flap surgery?
The most obvious benefit is, of course, the addition of a newly reconstructed breast. More specifically, because the reconstructed breast in a TRAM flap procedure is composed of natural tissue, the patient is less subject to some of the risks associated with breast surgery, such as implant rejection, capsular contracture, or infection. Additionally, the removal of tissue from the abdominal area as an effect similar to that of an abdominoplasty, or tummy tuck procedure, creating a more slender contour for the entire midsection.

What is the typical recovery time after TRAM flap surgery?
Patients heal at different rates and each has their own individual health considerations, so actual recovery times can vary significantly. However, after TRAM Flap breast reconstruction, patients can usually return to their normal daily routine within two or three weeks, and it may take between six and eight weeks for full recovery.
As regular lecturers at the SESPRS-sponsored Breast Surgery Symposium, Atlanta Plastic Surgery’s team of reconstructive surgeons is dedicated to advancing the field of cosmetic breast reconstruction. Click on our individual plastic surgeon’s links below to learn more about facial, breast, and body reconstruction procedures.

L Franklyn Elliott, M.D.
James D. Namnoum, M.D.
Joseph Kerwin Williams, M.D.
Allyson B. Maske, M.D.
Michael Mirzabeigi, M.D.