TRAM Flap Breast Reconstruction

The TRAM flap breast reconstruction procedure is currently the most common procedure for the transfer of living tissue. It is performed in two distinct ways, using the pedicled flap procedure and the free flap procedure.

For both forms of the TRAM flap breast reconstruction procedure, a strip of skin, fat and muscle is removed from the abdomen and used to create the new breast shape. In some cases, an implant may be added to the procedure to increase breast volume.

When to Consider a TRAM Flap Breast Reconstruction

Ideal TRAM flap breast reconstruction candidates are in good overall health and are interested in using their own tissue for reconstruction. You may require a breast reconstruction following:

  • Single or double mastectomy
  • Severely damaging lumpectomy
  • Chest injury
  • Deformity
  • Other types of failed reconstruction

Smoking may have a negative effect on wound healing, and you should discuss this with Dr. Mosiello prior to the procedure. If you have too little abdominal fat may you may not be a good candidate for this procedure.


What are the steps of the TRAM flap breast reconstruction procedure?

A general anesthetic or intravenous sedation is first given for your comfort. A strip of muscle, fat and skin is removed from the transverse rectus abdominis myocutaneous (TRAM) area of the abdomen. This removed portion is similar to the portion removed during a tummy tuck, which is one of the added benefits of this procedure.

An incision is made over the breast to be reconstructed and the flap is set over the breast. This incision may be made along the original mastectomy scar.

In the pedicled process, the original blood supply is retained, and in the free procedure, the flap is connected to a new blood supply. In both procedures, the breast is then shaped and the nipple created. The tissue is secured in place with internal sutures, and the incisions closed with very fine sutures for minimal scarring.

How long is recovery following the procedure?

Bandages and dressings may be applied immediately after the procedure. Drains may be put in place to remove any fluid buildup. A compression garment is often worn for the first few weeks to protect the breast, keep it in place and minimize swelling or bruising.

Swelling should begin to go down within a few weeks. At this point the final appearance of the area will become more clear.

Arm motion may be limited for the first few weeks, after which time a physical therapy program may be implemented. Regular activities can often be resumed in 2-3 weeks, but 6-8 weeks may be required before full recovery is complete.

Is there scarring from a TRAM flap breast reconstruction?

Typically the mastectomy scar is used as the new breast incision, which becomes an elliptical shape that extends across the breast. The abdominal scar runs from hip to hip along the underwear line for minimal visibility. There may also be a scar around the belly button.

The underlying tissues are secured with internal sutures to remove pressure from the external incision closures. These are secured with fine sutures for minimal scarring. Incision lines will continue to fade for up to a year.

How will I feel after the procedure?

There may be some discomfort in the stomach, breast and arm area for the first few days or weeks. This discomfort may be managed with prescription or over-the-counter medications.

Are there any possible complications?

A full discussion of your potential risks will be a part of your initial consultation. One possible complication of the TRAM flap breast reconstruction procedure is asymmetric breast appearance. This can often be fixed through surgical reconstruction of the other breast.

Poor blood supply to the new flap may also occur, which would require surgical correction. As in other surgeries of this nature, infection, poor wound healing and bleeding may occur.

Learn More About TRAM Flap Breast Reconstructions in Tampa

For more information about TRAM flap breast reconstruction, or to schedule a personal consultation with Dr. Mosiello, contact us at 813-631-1500. For your convenience, our Tampa Palms office is conveniently located in New Tampa, near Wesley Chapel.


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I love Tampa Palms Plastic Surgery ~ Dr. Moseillo, Mary, Nancy & Paula. I had breast cancer and reconstruction with Dr. Moseillo several years ago and knew I would never let anyone perform surgery on me other than him. I decided I wanted to do an Upper Blepharoplasty (upper eyelid surgery). I had the surgery a few months ago, am now at my summer home in Maine and everyone is commenting on how great I look. They have no idea that I had anything done! I keep hearing, “you have amazing eyes”. I am so thrilled with the results, feel 10 years younger and if you’re thinking about this procedure, or any other for that matter, do not hesitate to go to Tampa Palms

Tammy Ahearn

Dr. Mosiello, plain and simply put , is the BEST ! I did a lot of research and he was the one I chose and am very thankful and grateful that I did, as I had consulted with other plastic surgeons from other cancer centers. Dr. Mosiello surpassed in every area. He and his staff truly care and are warm, friendly, compassionate and knowledgeable. Which takes the stress out of any pre surgery or procedure. Knowing you have the best surgeon in your corner is the most important part. Post surgical procedures look amazing and he has saved my life, and has made me whole again. Look no further, he IS the best.

Stacy Kurnot

Dr. Mosiello taught me how to live again after having breast cancer. His staff is truly a blessing. He is an amazing artist and a wonderful Doctor and friend.

Susan Harrigan

I came to Dr. Mosiello’s practice as a reluctant patient who had just been given the diagnosis of breast cancer. I have been in several doctors’ office’s during my diagnosis and treatment and Dr. Mosiello’s office is my favorite. He is a very kind, competent surgeon who patiently answered questions and explained things fully. I was given clear post op directions and checked on by the nurse before my first post op visit and someone was always available if I had a question or concern. His staff is amazing! Melissa, Paula, Mary and Carol are all very personable and caring. This is also an office where I did not wait long periods of time to be seen. Things run smoothly and timely. I would highly recommend Dr. Mosiello to anyone in need of a plastic surgeon.

Melissa H

Dr. Mosiello is an absolute pleasure and privilege to have when in circumstances requiring his knowledge and care. His staff are fantastic as well, all welcoming with a kind smile. Highly recommend this is a doctor and team you can put your trust in.