The TRAM flap (transverse rectus abdominis muscle) procedure involves the transferring of skin, fat and muscle tissue ("the flap") from the abdominal area to the mastectomy site. The Flap remains attached to the original blood supply and tunneled beneath the upper abdominal skin to the chest and formed into a new breast mound. A TRAM flap sacrifices one or both abdominal muscles to supply the blood flow to the flap. The patient is left with warm, living tissue, however the TRAM flap carries many disadvantages. Many doctors do not recommend or perform the TRAM flap procedure because the risks are far greater than any benefit.
One critical disadvantage of the TRAM flap is donor
site morbidity due to poor blood supply to the skin and fat. With the
sacrifice of all or part of the abdominal muscle the side effects can be
long lasting or permanent, as well, and the possibility of abdominal
weakness, bulging or hernia can occur.



