Autologous Reconstruction (Muscle-sparing Free TRAM Flap)
This method uses your own fatty tissue and skin from the lower abdomen without the need for an implant and with an added benefit of a full tummy tuck. When a patient qualifies to have the muscle-sparing free TRAM flap the lower abdominal fat and skin is used and transferred to the chest area and shaped into a new breast.
Unlike most TRAM flap reconstructions; this operation does not remove the whole length of the muscle but only a small portion where the blood supply to the overlying fatty tissue and skin is present. This area of the lower abdominal fat and skin is then transferred with the use of microsurgery to the chest area and shaped into a breast. This optimizes the circulation to the newly reconstructed breast, while minimizing the amount of muscle removed from the abdomen which minimizes the chances of a future abdominal wall muscle weakness or bulging. The free TRAM technique is specially used in younger, physically active patients and those who need bilateral breast reconstruction.
Due to this better blood supply the flap that is transferred to the chest can be shaped and contoured to best match the opposite breast. The newly reconstructed breast often has a more youthful or a more up lifted appearance such that many women request a reshape or lift of the opposite breast. Any type of symmetrizing procedure to the opposite breast including insertion of implants in a patient with a history of breast cancer is considered a reconstructive procedure and not cosmetic with respect to federal and Medicare reimbursement guidelines.
