SamEyeYam

Kay,

I had a tram 7 months ago and I can wear low cut shirts.  We're talking I go to the junior section and pick out low cut things now and the scar doesn't show.  I even wear bikini swimsuits now.  Although some of the REALLY skimpy ones would show a bit of the scar near the center of my chest/cleavage.  I tend to stick with the bandeau (clamshell) type bikini tops and the scars don't show at all.  Now keep in mind that I'm a small B cup.

My lower scar is down on the bottom of the breast and I almost have to pick my breast up to see the underneath part of it. 

I just took a ruler and measured from the base of the middle of my throat (top of rib cage) diagonally to my top scar.  It is 6-1/2" away.  I am a petite, 5' tall lady.  So as you can see that is quite a ways before the scar starts.  So far there has not been a single piece of clothing I haven't been able to wear.  So unless you are dressing like Cher, you're probably going to be in luck!

I only needed 1 breast reconstructed, so I do notice that my cleavage is not perfectly matched on both sides.  But it's close enough and I really don't think anyone has ever noticed.  When I do wear something lower cut I generally have to lift my reconstructed breast a little more higher into my bra, or wear the strap on that side tighter so it lifts a little more.  But other than that the average person can't tell I've had reconstruction when I'm wearing low cut shirts. 

I had a small hard spot near my cleavage immediately after my tram flap.  I asked the surgeon and he said that it was some muscle that he had to use to help build up the cleavage.  It would always be harder in that area and told me not to worry that it wasn't necrosis.  I'm 3 months post surgery and it still feels exactly the same.

I was in the hospital with my pedicle tram for 5 days and went back to work (desk job) on Day 9.  Although I was a bit stooped over for a couple of weeks and moved very slowly, I was still able to work.  I took pain meds the day I came home and then only Tylenol after that.  As far as sleep, I slept in my regular bed with a pillow under my knees.  The first 4-5 days at home were the most difficult as far as sleep goes, but after that I did fine.

It didn't hurt as much as I thought it would.  However, the pain that I did have lasted much longer than I thought it would.

Right now I'm 3 months out of my surgery and pretty much back to normal, except I won't be doing sit ups anytime soon.  I can vacuum, mow the lawn, do laundry, all those things.  Some tightness in my stomach, but other than that everything is fine. 

I had a tram flap 3 months ago and while my tummy still feels a bit tight, it does get better each day.  I can still do the laundry, vacuum and mow the lawn, so obviously it doesn't interfere with my daily activities.  Now I probably couldn't do a sit up if I had to, but that really doesn't bother me.  I agree with the other ladies, find a Diep surgeon if you can.  I was not a candidate for Diep and had to have a pedicled tram.  But overall I am extremely satisfied with my results and my tummy tuck!

After my mast., but prior to my reconstruction I had several areas that I could feel the bones.  Like you I kept asking my doctors and they all told me they were bones.  Now after my reconstruction I don't feel them anymore because they are covered by fat & muscle from the tram flap. 

After having several doctors and nurses tell me they were just bones, I eventually quit worrying.

I had my tram flap on 3/25 and my room was kept very warm for about 3 days.  They gave me a private room because of the high temp.  Plus every few hours they would bring me a warm blanket to put over my new breast.  The doctor said it keeps the blood vessels from constricting due to cold, thus making a flap failure less likely. 

While 80 degrees sounds warm, when you are laying in a hospital bed not exerting much energy, it really didn't feel that bad.  I know that every nurse that walked into my room was sweating right away, but I was very comfortable.  It also helps cut down on the unwanted visitors!LOL!!

Since this got bumped up, I'll give an update on my pedicle tram flap.  This weekend I will be officially 2 months out of my surgery.  I am still extremely pleased with the results.  Joined my girlfriends for a fun weekend at Disneyland last week and this week I started doing aerobic exercises again.  Nothing to difficult and still taking it easy on the belly, but feeling really good.  Was able to wear low cut summer shirts and a bikini on my trip!  Can you believe it, a bikini!!!

By the end of the day I still feel a little pain in my belly, but that is probably due to a long day at work and sitting in a chair most of the day.  A couple of weeks ago I noticed that my new breast softened up quite a bit, now it seems to have a bit of a jiggle that it didn't have before.

My doctor told me the first 4-6 weeks that I had a 10 lb. lifting restriction.  Then for the rest of my life he recommended no more than 25 pounds.  I lifted an 18 pound bag of cat food at the grocery store yesterday with no problems.  When I do lift, I make it a point to use my leg strength as much as possible.

Honestly, other than the tightness in my abdomen and weight lifting restriction I don't feel limited at all.  I can do situps, but not a lot of them yet and I still do them rather slowly. 

My PS has encouraged me to do low to moderate exercise after 6 weeks.  He feels that strengthening the muscles all over your body, especially on your sides helps to overcome the weakness you experience from having your abdominal muscles cut.  He told me he had one patient that runs marathons and another in her 60's that is an avid mountain hiker after there tram flaps. 

I don't for a minute regret having the tram flap and as I said before I am thrilled with the results.  I did go into the surgery with a realistic expectation.  I know this isn't going to be an identical match to my other breast (but it's awfully darn close), that I may never regain feeling in that area.  But I've got to say I'm really, really enjoying wearing low cut shirts, bikinis and lingerie again!  I feel like I'm almost back to being the person I was before my mastectomy.

I went back to work 9 days after my tram flap.  Granted I have a desk job and didn't have to do anything real strenous.  I only missed 7 working days.  I had to wear real loose clothing and by afternoon was walking stooped over.

That being said I have a very high tolerance for pain and hate sitting around the house.  I would much rather be at work and keeping my mind busy, even if I am in pain.

I wanted a Diep, but couldn't mainly because of my prior abdominal surgery.  I had a c-section (plastic surgeon said that was not a problem).  But I also had an exploratory surgery when I was 5-1/2 months pregnant.  Ended up it was my appendix, but because they didn't know that going in, had a very long scar across the middle of my belly, rather than the usual small lower placed one.  That COULD be a problem my surgeon told me. 

I told him I didn't care if my scar ended up on my breast, but that was not the problem.  It is what the other surgeon did internally that can cause problems.  They may have cut part of the blood flow and it is really the unseen that can cause problems. 

Because of that big unknown I opted to go for a pedicled tram flap so we could be sure of a fairly good blood supply.  As it ended up my plastic surgeon was able to make the breast without using the portion that had my external scar. 

Going into my surgery my surgeon and I still weren't sure of what exactly would happen, which side of my stomach would be used, if it would have a good enough blood flow, if they would be able to flip the tram upside down and twist it as they normally do, etc.  We discussed the scenarios and I agreed to go ahead with the surgery.  Everything did turn out ok.

But please just know that having abdominal scars from prior surgeries can make your surgery a bit more tricky and can limit some of your options.

Thanks everyone for the info.  I am meeting my PS for my final pre-op appt. today.  When I met with his assistant last week she told me that a bra type binder would be provided, but I didn't think to ask about the underwear. 

I am a little concerned because my PS said that her prefers not to use mesh, instead he spends more time sewing things back together so they will heal properly.  He said the less foreign objects that are placed in my body the better.  However if he sees a need he will use mesh.  I thought that kind of odd that a PS would say that about foreign objects in the body, when obviously breast implants are usually their bread & butter!

My PS is with Kaiser Permanente HMO in Portland, OR.  They only have 2 PS and they concentrate on necessary reconstructive surgery instead of cosmetic.  Which makes me feel pretty good.  Plus, I am very impressed with his reconstructive photo book.  He has a few that don't look great, but most of them really look good.  Both of them will be involved in the surgery and I recently seen 1 of them listed in the Portland Monthly magazine as one of the 3 best plastic surgeons in the city, as voted on by other doctors.

Originally I wanted a Diep, but after consulting with PS in Seattle that does Diep and 2 PS here in Portland I have come to realize that the pedicle tram is the right surgery for me.  My HMO was happy to give me a referral to any Diep PS in the US that I wanted to go to, no questions or hassle whatsoever.  My PS at my HMO even called a few other PS in other cities that performed Diep and consulted with them.  Everyone was of the same opinion that I was probably a better candidate for the pedicle tram flap.

One interesting thing my PS told me was that if I really, really wanted a Diep (even though it wasn't recommended for me).  That he didn't recommend anyone on the West Coast for a Diep.  He preferred that I go to a high volume Diep hospital such as Johns Hopkins, NOLA, etc...