Has anyone had a good experience with TRAM FLAP reconstruction?

[SueYoung55]

I met with my plastic surgeon yesterday and he said I could do a tram flap reconstruction on my breast. I got home and started reading all the posts about the issues folks are having with this surgery and I wondered if there are any success stories about tram flap surgery. Also, for those of you who have had issues with this surgery, what would you have done different, knowing what you know now?

I did not research this before my appointment because previously he told me I did not qualify for tram flap, only taking muscle from my back.

He said he would tunnel one muscle up to create my right breast and instead of using mesh, would use "pig skin" in it's place in my stomach area. I've read about that too and it says it becomes a part of your body. So, if it blends in to your body, what supports that area? Does it stay strong enough to keep you from bulging and/or hernias?

I'd like to know what can really go wrong with this and how often it happens.

I'd really like to hear from the Doctor, and from anyone that's gone through this with positive feedback too, since this will be scheduled for April unless I change my mind.

Are there any success stories out there? I don't want to just read the bad issues that can happen and only have one side of it to scare me out of reconstruction. I want to weigh the good & the bad and I need your help if you have a moment to respond.

Thank you for your time.

[Archibald S Miller III, MD,FACS]

You have suffered the worst problem a tram can have and that is the failure of the flap. It is hard to deal with physically and psychologically. What is worst is that one cannot know which patient will suffer this catastrophic problem. One can only maximize the chances for successful outcome. That is why a good experienced surgeon should be sought out, and the surgeon be familiar with how to deal with the problems as well as the good outcomes. I am sorry you had a bad outcome, but do be aware that you still have several good opportunities to have a reconstruction. Have a great day.

                                 arch s miller ms md facs

[hihedwig]

Hi there--I had my tram flap surgery done on Dec 1st and it was a disaster. Half of the newly constructed breast did not get enough blood supply and literally rotted and died. I have NEVER smelled anything that bad. It became infected twice and now I am still in recovery because the hole which was size of a mandarin orange needs to grow in. Once it's grown in it will not be complete. I may just let it heal and be done with it. I have had a very tough time. I would not recommend it to any one. I am 60 yrs old and regret having done this specific surgery.    Hilde

[Tripearl]

If I had answered this question prior to about 2 yrs ago, I would  have said, my tram flap was a success story. My operation was in July 2002. But for the past 2  years, slowly over the course of time, and now, constantly, I have the feeling in my stomach of like a hundred pound weight pulling me down. It was only when I asked this question in this forum, did I get the answer about this, that my plastic surgeon never addressed. So,  for me about 5 yrs after the fact, I have to say I wish I had not had it done...ask a 1000 questions, and I wish you all the best as you go forward..

[Archibald S Miller III, MD,FACS]

I have done many procedures over the last 25 years with the tram. It is a very successful surgery, and it has been used probably thousands of time for reconstructions. I do however, want to advise all of my patients that the surgery does have major problems when they do occur. The biggest problem or most frequent is the development of abdominal wall weakness. This can be immediate or take several years to develop. This can be improved, but it is irreversible because the muscle is removed.  The second biggest problem is recovery as it is a big operation and can take up to 8 weks to recover from. But, once recovery is complete, all is well. There are other smaller problems or complications that do occur, but less frequent. One can have the worst one, and that is loss of the flap, with a need for revision surgery, and another type of reconstruction, but that is even less frquent.  Radiation is harmful to the tram so if you are going to have radiation I always advise patients to wait until it is complete.  I hope this answers some of your questions.  I do want to state that there are many women who are happy they decided to have a tram done.

                                         arch s miller ms md facs