Another option for some patients is another group of surgeries that involves using your own tissue.
The TRAM is a major surgical procedure that involves using your own abdominal skin, fat and muscle to create and contour one or both breasts. This surgery can be upwards of 6-12 hours of surgical time and a 2-4 day hospital stay. The recovery from this surgery, as compared to the tissue expander procedure, is a greater length of time. As with all reconstruction options, your surgeon will help guide you in choosing . This surgery is best for women who have some excess abdominal fat. Here, the Transverse Rectus Abdominis Muscle with fat and skin, is partially released and lifted up to form a new breast. Since your surgeon is harvesting this tissue from your abdomen, you also will end up with a tummy tuck but the abdominal wall will be reconstructed as well, with a piece of mesh. It is important to remember that this surgery will involve a scar across your lower abdomen and the breast area. These scars are all easily hidden with most underwear or swimsuits. Also, it is vital to avoid sun exposure to your abdomen for one year following surgery, since your skin may be sensitive to excess heat and could result in severe sunburn.
Since your new breasts are created from your own tissue, they may feel natural. However, the skin sensation and coloring will be different since the skin and tissue came from a different area of the body. Many women are however, pleased with their flatter abdomen as a result of the surgery.
It is important to keep in mind that only certain people are good candidates for the TRAM flap surgery. Since it can involve an extended recovery, it is very important to be fairly healthy going into the procedure. Smokers and those with prior abdominal surgeries, diabetes, chronic diseases, cardiac conditions, or on blood thinners may not be the best candidates.
Recovery from this surgery is longer than with the tissue expander process. Since your abdomen has been reconstructed, you must plan to be off work and avoiding any strenuous activity for about 8 weeks after surgery. It is important to have someone that can assist you at home during your recovery. Patients have multiple follow-up visits, to ensure that their healing process is on track.
Depending on the individual, sometimes another surgery may be required prior to the TRAM. This procedure is known as a "Delay in TRAM". The Delay surgery is normally performed two weeks prior to the actual TRAM surgery and works to improve the blood supply to the flap. During the delay procedure, blood vessels that supply the flap are divided from below. This promotes blood vessels from above to become larger and more robust, reducing the risk of vascular insufficiency to the flap. Dr. Burgess will determine whether you will require the Delay.
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Note about these procedures: When patients come in for a new patient consult, Dr. Burgess will review the various procedures she performs as well as discuss the other options available to patients. She will help guide you towards the reconstructive surgery that most compliments your aesthetic goals, as well as maintain close communication with your other physicians.