Breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap

What is a breast reconstruction using a transverse rectus abdominis myocutaneous flap?

This flap uses skin and fat taken from the abdomen between the navel and the pubic area to reconstruct the breast. Abdominal skin is the most suitable tissue for breast reconstruction in terms of appearance and texture. For the TRAM flap (transverse rectus abdominis myocutaneous flap), one of the two transverse rectus abdominis muscles is sacrificed to ensure that the flap is supplied with blood. This causes major weakening of the abdominal muscles, which may lead to bulging of the abdomen or even the formation of a hernia. In addition, the blood supply of the flap is not always equally reliable, which often leads to fat necrosis. This is why currently, the pedicled TRAM flap is used less and is best replaced with the (free) DIEP flap.