Bilateral pedicled V-TRAM breast reconstruction.
35 yo 5′ 5″ with left outer quadrant breast cancer with a pre op A – B cup breast size – desired larger breast volume post op. She underwent bilateral skin sparing mastectomy and same time reconstruction with a bilateral V-TRAM flaps. The “V” stands for the vertical component of the abdominal fatty tissue and skin that is located along the central most portion of the abdomen receiving its blood supply directly from the underlying abdominal muscle. The patient did accept a central abdominal as well as a transverse as in the traditional TRAM flap scars – that she traded in for a larger and all natural bilateral breast reconstruction. The abdominal donor sites are repaired with both an in lay as well as an on lay mesh to reinforce the abdominal musculature and secure a problem free long term abdominal wall integrity. The patient has since undergone bilateral nipple and areolar reconstructions and the breasts remain soft and natural maintaining their shape and contour.
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