Topic: Tram Flap Reconstruction

Hi Wessel I only had one side done masectomy and tram flap 12 hours . Good Luck. God bless you.

I had a bilat mast and tram flap recon and the surgery took 6 1/2 hours. I think it depends  on how many your surgeon has done and how good he is. The first surgeon I saw told me it would take 10-12 hours. I got referred on from there and the surgeon I used said 7-8 hours, but it was 6 1/2. I was off of work for about 8 weeks, but I teach and it is pretty intense. If you have a desk job, maybe you could return sooner. If I can help you with any other questions, let me know. Hope all goes well for you.

Hi. My mastectomy and TRAM took 8 hours. I had radiation treatments 3 weeks after it was done that lasted for 5 weeks, and took another 4 weeks off after that before I went back to my desk job. I still wasn't 100% then and it was obvious to everyone. Giving yourself time to heal from all the treatments you've had done is as important as the treatments themselves. Don't hurry yourself. Also, don't judge your satisfaction with the outcome too soon. I wasn't at all too keen on it immediately after I had it done, but that was 4 years ago, and now I'm really happy with it.

I had a skin sparing mastectomy with an immediate tram flap reconstruction five years ago. I think the total time was 8 hours or longer.  I had mesh implanted over both sides of my abdomen from my ribs to my hips.  Twice it has dislocated from the faschia it was attached to, leaving me with a large bulge, due to the intestines pushing outward.  I will not have it repaired for a third time as it is a major surgery that I do not care to endure again.  The tram flap is the most difficult surgery of all reconstruction choices, but give the best results.  I am very happy with mine all things considered.  The results are amazing.  Love the tummy tuck!  I would not go with a free flap b/c of the increased danger of a failure.  I would instead research and consider the DIEP, making sure I had a top notch plastic surgeon!  Good luck! Michele

I'm also a fan of DIEP. My onc referred me to a very skilled PS--as well as other patients. I wouldn't want to consider moving muscle, especially since Pilates has eliminated chronic back pain and I'm very active. When I asked my onc about whether a DIEP would mean I would have to restrict my current activities, he said that he has 2 pts--one who teaches Pilates and a cardio fitness instructor--who have been very satisfied w/their DIEP surgeries.

I'm delighted w/mine though it took longer than others (12 hours) because I am very thin and he needed to take the entire abdominal flap for a unilateral reconstruction.

I know that the free flap is less invasive than the tram-flap, but still has more side effects. I know that everyone's situation is different, but I traveled, not only for the DIEP but oncology and my original mx after the 2nd surgeon I met w/told me "you won't get the mx you want out here."

I know that there are others here who also have traveled. If possible, I'd consider it. Feel free to PM if you'd like.

I traveled from my home in Los Angeles to New Orleans and would not hesitate to make that choice again.  It was really easy, given that the doctors have arranged transportation via limousine to/from the airport, and for all appointments and surgery.  See www.breastcenter.com for the NOLA doctors' website.   Four hours on a plane was nothing--I would have been resting in my recliner for four hours at a time anyway. 

Sandy

I believe that when a free flap is mentioned, it is the muscle-sparing (MS) free TRAM flap surgery, which I had.  A very small piece of the muscle is taken, as opposed to the pedicled TRAM.

A pedicled TRAM has the muscle and fat kind of "snuck up" under the trunk skin into place at the "new" breast area.  The DIEP and the MS free TRAM are cut free, then inserted at the breast site.  The biggests diff between the last two is that no muscle is taken for the DIEP while a small piece is taken for the free TRAM.

I had a MS free TRAM at the end of March of this year and was standing up straight within a week, had no pain and gradually increased my activity over a few weeks to the point where my abd. strength was the same as before the surgery.  Perhaps I was lucky in this in that I have heard that sometimes even the small amt of muscle taken can cause some weakness in that area. 

There is a small risk of hernia or abd. bulge after the MS free TRAM flap as opposed to practically no risk after the DIEP.  However, considering my own experience, I would encourage anyone to consider the MS free TRAM if they did not have access to an experienced DIEP surgeon.

Thanx. Now I understand. I am glad that the MS free TRAM flap worked so well for you.  It is good to write about the different options available so people reading here can be maximally informed.

I just had a DIEP surgery- after waiting 11 years!  I now wish I had done it sooner- but I only discovered it as a possibility in the last few years. When I inquired in the past- I was offered a pediculed TRAM or a Latissumus D flap. I was told that the implant option would likely not work that well since I had had radiation.

While living with a prosthesis for so long was awful, I did get to a place where I sort of got used to it and sometimes forgot about it. I  would then have rude moments of awakening when I needed to get dressed up, or went shopping, or when  friends celebrated a 45 birthday at Olympus spa where you all walked around naked. These moments were horrible.  I am only now allowing myself to fully verbalize and realize how much they bothered me. Then of course there was the moment when you lean over to pass a colleague a pen and you grab your shirt because in the leaning the prosthesis gaps forward and perhaps the emptiness could be glimpsed.

 LL

HI, I had the MS free tram flap where they take only two strips of muscles. They didn't take all the muscle. I was off work for two weeks and went back to work part time and worked from home until I gradually got to feeling like I could stay a whole day at work. It wasn't too bad. I get so confused when we talk about DIEP, free tram flap, MS tram flap etc. So all I can base mine on is what my doctor called it. The surgery took about 9 hours. He is a very experienced doctor but wanted to make sure everything was attached properly and would survive afterwards.

They came in and listened for blood for every hour for the first two days. I think the biggest thing is being tired. I couldn't stand up straight for a good week but gradually got better.

My co-workers couldn't believe I was at work so soon. I just didn't want to stop and sit at home and dwell on the fact that I had just lost both breasts and that cancer was the cause. I kept busy.

Hope this helped.

Penny

I hate to be negative since you are excited, but sometimes a PS will tell you you are not a candidate for free flap because he/she doesn't know how to do them.  PS recommend procedures that they are comfortable with -- if you really want a free flap, it might be worth another opinion from someone who has experience with them -- if not, best of luck with your surgery.

I am home recovering from a tram flap; it took 8 hours and 6 days in the hospital. I'm able to walk ok but sleeping is hard. I sleep best in a recliner. I've had some circulatory issues so have some "dead" areas around the flap wounds but my PS feels it will heal ok but slowly. Originaly was told I can go back to work in 3 weks post op but I never believed that! I'm post op from 12/18 and don't expect to return to work for another 3 weeks or so. we'll see. It was quite painful the first week but less and less thereafter. Now only slightly. If I had to do it over, I would. When I'm all healed I feel the results will be worth it. Good luck and be posative!

Sue