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Topic: abdominal bulge after tram flap

Forum: Breast Reconstruction —

Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Jul 14, 2008 06:10PM

bebe wrote:

I am 5 years out (YAY!) from unilateral mastectomy & my tram flap reconstruction surgery.The bulge on the right side of my abdomen is very uncomfortable & I am very self conscious about it. Onc says it is not a hernia,,,Anyone else have this problem? Has anyone had surgery to correct it?

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Jul 14, 2008 07:16PM karenmary wrote:

First of all, congrats on being five years out!

I'm only two years past bilateral mast and tram flap. I started to develop a bulge and became suspicious that it was dietary -- I had upped my fiber intake and had gained a bit of weight and was uncomfortable each and every day.

I stopped with the high fiber foods I was eating. I'm also on losing some weight; my weight is slowly headed back down to where it was at the time of my surgery -- and I haven't been bulging in a while. I think it was those two things and not a real surgical need.

Any chance you're in the same boat?

www.pinkribbonreview.com Dx 4/2006, IDC, <1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 14, 2008 07:32PM sam408 wrote:

Did you have a ped tram? I had my ped tram on 4/2 and I have a goose egg shaped bulge in my upper abdomen that is still very tender. My PS says it's where the muscle was turned and that it may go down some but will most likely always be there. No bulge like this was ever mentioned in all the research I did, so I'm hoping it will go down. It's not real bad when I'm standing, but it's really noticeable when I sit down, especially if I have on anything that's fitted. I'm going to give my healing some more time and then if it's still big, I'm hoping she can do something to it.

Have you asked your PS about it?

Sheila . . .Never regret something that made you smile. Dx 2/16/2007, DCIS, <1cm, Stage 0, Grade 3, 0/4 nodes, ER+/PR+, HER2+
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Jul 25, 2008 06:18PM LoriFL wrote:

I have a bulge on the side of my mast. I thought that was how your stomach was supposed to look like....lopsided!

I had a tram flap too and have lost my waist. Is anyone else having that problem? Clothing just falls off this straight body...no curves.

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Jul 25, 2008 10:21PM RRR wrote:

I've lost my waist too.  I have been tucking my camisole in my pants to give them some grip. It's still too tender for a belt, my jeans are droopy from weight loss. Even my undies have a hard time staying up. It's been three months for me since the TRAM. Everything is great below the abd incision but above still tender and bloated.  I am sticking to dresses for work so I don't have to walk around hiking stuff up.

Dx 7/5/2007, IDC, 3cm, Stage IIB, Grade 3, 1/25 nodes, ER-/PR-, HER2-
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Jul 26, 2008 06:08AM - edited Jul 26, 2008 06:09AM by pinoideae

This Post was deleted by pinoideae.
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Mar 15, 2009 08:07PM ctinasworld2003 wrote:

Congrats on the 5 years, I approaching mine in November.  I have a bulge, my doctor tells me it is not a hernia, still pretty unsure about it, he said he would explain this in more detail. I am scheduled to have it repaired on Friday, but it looks as though I need to take care of a family emergency first. I had the tram flap last April, all was good until October, since then it is quite uncomfortable, enough to wear a binder when I know I will be taking a long walk.

Does anyone know if this is potentially dangerous to prolong repair?

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May 5, 2009 12:37PM nancyu wrote:

If they are at the ends of your incision lines, the are sometimes called "dog ears" or "Bat wings".  It is common after the initial surgery.  My plastic surgeon, a very well-known, kind and gifted woman, lipo'd them when I had the revisions to my breast.

Nancy Dx 4/2007, IDC, 3cm, Stage IIIA, Grade 3, 5/18 nodes, ER+/PR+, HER2-
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May 5, 2009 01:17PM ghety wrote:

Just like RRR, I am 3 months out from my tram and below the incision seems/feels good. Above the incision bloated, tender, weird. Heard someone on here refer to a frog belly and I have adopted that name for it because that is what it feels/looks like to me , actually makes me smile a little to think of it as a frog belly ;).

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May 22, 2010 12:48PM exc187 wrote:

I had extremely large and painful dog ears which the surgeon lipo'd when I had revisions to my breasts.  My Dr. said the insurance co. would pay for them, but now, after the surgery.  They have denied my claim.  They said it was cosmetic.  Can any one help me with info for my appeal.  The surgery eleviated the pain in my abdomen, but they still won't pay

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Oct 31, 2010 07:29AM - edited Aug 20, 2013 03:03AM by thoughts5000

I had  bloating and went to my gastroenterologist. He felt the bacteria in my digestive system became unbalanced due to all the antibiotics I took post surgery. He prescribed another antibiotic, xifaxan, to kill all gut bacteria, and then started me on daily yeast pills which can be bought over the counter. The difference in my bloating "frog belly" is amazing...

Dx 6/2008, <1cm, Stage I, ER-/PR-, HER2-
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Oct 31, 2010 05:15PM FLtricia wrote:

Bebe,

I am two years out from DIEP reconstruction.  I, too have bulge, on my lower right side.  Doctor tried to repair during Stage 2.  It lasted a few weeks and one day, I simply reached to get my glasses off the table and felt the stitches give.  My PCP thought it was a hernia but scan proved her wrong.  They said it was a tear in the fascia which is on top of the muscle.  I hate it.  But after the failed attempt to fix it, I just don't want another surgery.  Mine starts out pretty small in the morning, but gets larger as the day passes, very uncomfortable on active days.

At least I know now that I'm not the only one.

Dx 9/25/2006, IDC, 1cm, Stage I, Grade 1, 0/16 nodes, ER+/PR+, HER2- Dx 5/2013, IDC, 1cm, Stage I, Grade 1, 0/6 nodes, ER+/PR+, HER2-
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Dec 14, 2010 07:57PM Shae153 wrote:

Hello Ladies

I had TRAM flap, and reduction on my healthy breast on September/02/2010. Unfortunately, I did not get the desirable result.

1. Still there is a huge difference in size in compare with the healthy breast. 

2. I am very exhausted because neither I got the same size of the healthy one but there has been added  a bulge at the site of surgery.

I am wondering if you have the same problems or not?

Dx 2005, stage II, 2.5 cm, 1/14 nodes, HER2+, DCIS.

Dx 10/15/2005, DCIS, 2cm, Stage II, 1/14 nodes
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Jan 23, 2011 06:40PM deudey wrote:

I had my double mastectomy and tram flap reconstruction surgery in October of 08.  From the beginning I have had many complications.  My belly button "died" and I had an oozing hole for several weeks while it healed.  (had to wear a wound vac for quite a while).  Since then I've had hernia repair surgery 3 times and none have been successful in relieving my abdominal bulge and discomfort.  My most recent attempt to get some help ended in being told I needed to learn to live with the problem.  Two Dallas doctors recommended I wear a binder, take Advil for the inflammation and maybe try Spanx.  All of these things I have tried, but none have given me the relief I need.  I do not believe that tram flap should be offered as an option for reconstruction surgery.  Also my breast reconstruction didn't go very well either.  My left breast is OK, but the right breast has a considerable amount of hardness due to the tissue used not getting a blood supply.  If you should be facing a decision about breast removal and reconstruction I would like to warn you about the many complications that can occur when having a tram flap.   

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Jan 24, 2011 08:37AM Binney4 wrote:

Just wanted to add that abdominal lymphedema is possible following a TRAM. It could involve only a small area of swelling or a much broader area. Might be worthwhile to request a referral to a well-trained lymphedema therapist for evaluation (and baseline arm measurements as well -- hey! we're all at risk for arm lymphedemaUndecided). You'll also get personalized lymphedema risk reduction suggestions and possibly be fitted for a compression sleeve and glove you can wear prophylactically for exercise or travel. Win/win!Smile At any rate, if any of the bulging going on in the abdomen, breasts, or near the axilla is lymphedema, the treatment is a very gentle, relaxing massage called Manual Lymph Drainage, and the use of compression to keep any fluid from re-accumulating. Here's information about how to find a qualified lymphedema therapist near you:

http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

Just a thought....
Binney

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Jan 26, 2011 05:21AM Onetoughwoman47 wrote:

To all - I too, have bulge on lower left ab area, right above scar line.  I just had T/E placed on right side and had ab area done after botched TRAM in Nov 09, however nothing was stated about bulge or potential of having one, yes, this is area where no muscle is, obviously what was taken from my left side into my right breast, and it caused 3 tracks to have embedded sutures that are NOW rising to the surface.  I will be having a re-con on this TRAM and ab area march 18th at which time "mesh" will be placed over the bulging area, the other option is "live with it", I'm opting to have it done because of the type of lifestyle I live and my line of work. Basically I will have everything re-done underneath to clear up tracks and suture problems, it goes much deeper than he thought (after finding this out Jan 7th).  I'm healthy enough and in good enough shape to go through this procedure and just want it completed the correct way once and for all...my PS is Dr. Fine at Northwestern in Chicago, just FYI.  very good and a credit to his profession....I've been very happy with his bedside mannaer and professionalism as well as his "openess" and honesty about me and my body and what he can and cannot do...Laughing
"Life is what you make it, always has been, always will."
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Jan 26, 2011 05:25AM Onetoughwoman47 wrote:

I agree though that everyone PLEASE check out your options before you have a TRAM.  I was told I had none(options) and was lied to.  I also had a doctor that didn't even want to see me again after his screw up!  The medical board will be hearing about this once I'm all finished, this isn't something you just sweep under the RUG!!!!

I suppose having FEDERAL Blue Cross/Blue Shield has a lot to do with all these surgeries and padded bills and statements I've been receiving, but thats for another THREAD! LOL

Hugs to all!!!!

"Life is what you make it, always has been, always will."
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Jan 27, 2011 05:33AM Onetoughwoman47 wrote:

Binney4 - sounds like what I have.  With support wrap I'm fine but without it, man, bulge, sore and fluid all around the tram tracks and such.  I'm having a revision March 18th, mesh and track cleaning, I can't possibly live with it, I've had other internal surgery (3 colectomys and ileostomy/reversal) and that is my weak side, that was done before this tram almost 2 years out and no problems with my plumbing....all works well but this side has been a problem since this tram in Nov 09.  I insisted that coudl we do something else to previous PS, but he said this was better way to go, since I was a swimmer cutting into and working on the Dortis woudl have meant mroe rehab etc....jeez, that would have been a pice of cake compared to the TRAM.

Thanks for your posts and all the ladies on here, happy to know I'm not alone with this.

"Life is what you make it, always has been, always will."
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Jan 27, 2011 05:43AM Onetoughwoman47 wrote:

Karenmary - yes, for me fiber has a lot to do with it as well, and since I have not been able to workout now for about 6 weeks, I will see a huge difference when I start back to work this Monday. I'm a swim instructor and am used to working out at least 15 hours a week or more.  I noticed the bulge wasn't as bad during that time and have also gained a few lbs. since leaving work for this surgery, which is fine for me, but I know in a matter of a week I'll return back down to my comfy weight (128 at 5'6")....until then the loose fitting clothes will have to do, I can't seem to find jeans low enough for on my lower hip so as not to rub againist this small hole/wound on my left hip...the surgery I just had jan 7th did not releive it all, this morning wound at my belly button site that he had cut and fixed opened, fluid coming out, I knew this was only going to be temporary.....disappointing as it is, it will be corrected completely March 18th.....sigh.

"Life is what you make it, always has been, always will."
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Jul 4, 2011 08:14AM dannade wrote:

I had a "DIEP" flap reconstruction on left breast DEc. 7, 2010.  My PS told me he had to take a small cuff of muscle to protect the vessels.  According to definition, the DIEP turned into a Free Flap, but he still calls it a DIEP.  My tummy never lost inches like I was told it would and women on the DIEP part of this site all have lost inches.  I, however, have gained a tummy bulge which is not a hernia, but weakening in the muscle which was compromised for the vessel. My PS is hesitant to do anything about it as there are no guarantees.  I saw a General Surgeon for second opinion.  He said the same thing and that there is nothing to be done about it.  I had one revision so far and the breast is still too flat (trying to match the right which has an implant in it).  So, I still need another revision,  maybe a small 100cc implant on the left.  Has anyone had repair for tummy bulge?  It is painful especially if I've used my tummy muscles throughout the day.  In the beginning when I complained about tummy bloat and bigness, the PS had me doing crunches and I'm sure I was not doing them correctly.  And he had me walking, which irritated my knees and now I need knee replacement.  Geez, I felt good 2 years ago before all this.

Dx 8/28/2009, ILC, Grade 2, 3/3 nodes, ER+
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Aug 1, 2011 11:00PM tundrabunny wrote:

Would love to hear updates on everyone's bulges. My bulge started when I went back to the gym three months after my delayed bilateral diep flap reconstruction. After ovarian cancer and others were ruled out with ultrasound, CT, and bloodwork, my PS told me what I have isn't a hernia, but a bulge cause by the facsia stretching where they teased the vein from the muscle. It hurts like a knife stabbing when I sneeze unexpectedly or get up too quickly. It feels like there is always a big ball in the way. It started as small as an egg and now it feels like it goes from the pubic bone to above the navel. He did offer to do a repair where he would put a mesh attached to the pubic bone to the ribs. He said it was quite painful and i'd have to wear the binder again for another 4-6 weeks (that was the biggest turn off). So for now I have opted to not have the repair, but can't see going the rest of my life with this bulge!

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Oct 3, 2011 09:31PM happihawaii wrote:

Hi, I am living with a bulge that has been increasingly getting larger and larger and appears to be ripping right across my body from the left side and feels like it is tweaking my belly button on its way as it gets larger. I had Diep flap surgery on 4/08 and then a repair  to the bulge that occurred with mesh 10/08. Immediately after, there was a tiny bulge that just has gotten very large. It didn't not hold at all. I had inferior results from the left breast mastectomy with immediate reconstruction where the front of the skin died and the surgeon after a week pulled skin about 2 1/2 inches across together and now there an upside down breast form as it can never relax and look like a breast as there was just not enough skin. As far as the bulge, I am also afraid of more surgery as the entire thing has been one bad deformity inside and out every time. It is now three years later since the bulge repair and it is not good. I am glad I have seen this site as I have no one to talk to about this as the doctors have nothing to tell me. Wear a binder which is fine for  awhile around the house or a walk , but not for dressing for my work. Yes there was no warning that this waas even a remote possibility when I initially went for consultation for mastectomy. I don't know what to expect in the future. It is very deformed lokking ans feels as someone described as as frog belly bulging. When I sneeze I try to grab hold and push in lest I feel like I will rip more every time. I have seasonal allergies and that is a real problem!!! Violent sneezing often. 

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Oct 3, 2011 09:34PM - edited Oct 3, 2011 11:40PM by Moderators

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Oct 3, 2011 09:37PM - edited Oct 3, 2011 11:41PM by Moderators

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Oct 4, 2011 01:53PM shelly56 wrote:

I didn't have a tram procedure, but bilateral DIEP.  I do have the tummy bulge and I guess I probably always will.  I'm sad because a big reason for me to go this route was to take away the excess tummy fat ( or most of it).  Just saw my PS for checkup in July and he says to wait a year before doing any more revision, i.e., still need to even out.  Left side is a "c" cup and right side a "b".  Geez how in the hell do they know how much fat and tissue to plug in somewhere else?? I'm thinking its more of a guessing game than anything -- that's bad. 

Does anyone else have the uneven look after the DIEP and minor revision? 

--Shelly

"Courage is resistance to fear, mastery of fear - not absence of fear." Dx 1/26/2009, IDC, Right, 6cm+, Stage IIIA, Grade 3, 4/15 nodes, ER+/PR+, HER2-
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Jan 17, 2012 05:59PM ncjsquared wrote:

Hi all,

I am so happy to know that I'm not alone in this!  I underwent a bilateral mastectomy in March, 2009 with tissue expanders being placed at the same time.  It all went downhill from there.  Long story short, I had a TRAM in April, 2011, to replace the breast on the right side only.  Like so many of you, I have a bulge that my PS says isn't a hernia, and if I want it corrected, to see a general surgeon.  I've been trying to get back into shape, and it any activity that involves my abdomin is uncomfortable.  It's at its worst first thing in the morning.  I suppose I could try to use the binding that PS provided right after surgery, but this is just, well . . . deflating. Hey!  I'm alive!  What's a little bulge?!

Dx 1/26/2009, ILC, 3cm, Stage IIB, 2/11 nodes, ER+
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Mar 8, 2012 04:49PM carole743 wrote:

I had a double mastecomy on Jan 19, 2012 this year and have had problems since then.  First part of my surgery on Jan 10th a nerve was cut or stitches and I was in bed with pain for 9 days.  Didn't know what it was until they went in to do the mastecomy that they found out what happened.  In the hospital for 5 days and sent home.  I had 7 draining tubes, after tubes were removed I continued to have drainage problems.  I would go to the PS and he would insert a needle and remove the fluid that was building up.  It started at 160cc and has gone down to 10cc's.  On Friday, he sent me to have an unltrasound where the Radiologist took off 50cc's.  I just went back today and he looked worried because my stomach is as hard as a rock and it bulges out.  Sure my lower part is flat but below my breasts it sticks out and looks terrible.  I started getting a rash and he put me on antibiotics and cream for the area.  For 10 days I took the antibiotics and the rash is not as bad as it was but it just feels raw and still hurts.  Has anyone had this problem.  I can't go back to work because I still am not allowed to lift because he doesn't know what is going on inside my body.  I think I might request an MRI.

Carole
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Mar 12, 2012 05:52PM gagirl1990 wrote:

Hey Carole. I just read your post.  I had bilateral mastectomy Feb. 2011.  Radiation last summer. Reconstruction with TRAM Flap in November.  My PS is wonderful... absolutely love him. But like many of the other posts on this subject, I did not know "frog belly" was a possibility.  My PS put mesh in at time of reconstruction to prevent possible hernia.  I stayed out of work til Jan 9.  No problems with surgery itself.  But after I went back to work I noticed my abdomen started swelling.  Have the same problem as you... sitting looks awful.  Can't stand to wear fitted clothing.  All I've been told is that this is one of those possible side effects and hopefully it will go away.  I've tried changing my diet... done research on bloating... cut out sodas... eat more yogurt.. nothing is helping.  Have you found out anything new? Very pleased with the reconstruction on my breasts... very disappointed on the bulge.

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Mar 16, 2012 07:34PM bdavis2 wrote:

I had surgery feb 3.  Mastectomy of the right breast and reconstruction and also  reduction of left breast the same day.  If I wasn't so afraid of losing my job I wouldn't have chosen all in one day.  Went back into surgery Feb 20th for a hematoma.  My upper abdomen is like a "barrel".  I'm assuming from what everyone is saying here that it will never go away.  My reconstructed breast needs revisions and my left breast needs a lift because the reconstructed breast is so high. 

Do the moderators have access to any treatments or resolutions for lymphedema.  I know I should contact a Lymphedema therapist and will do that 1st thing Monday morning.  My upper abdomen gets bright red near the incision over quite a large area.  Even if I haven't eaten for hours my upper stomach stays full as if I have eaten three pounds of pasta.  If I had any inkling that this would happen I would NEVER have gone through with this operation but would have had an implant done instead. 

I kept hearing that this was the "gold standard" for reconstruction (diep that is).  I had my surgery at a top hospital on the East Coast.  I cannot find any clothes that fit me right.  I cry alot and feel my life will never be the same.  Don't plastic surgeons have to disclose all the things that can result from this surgery?  Has anyone considered a law suit? 

I'm really really sad about what has happened and it has changed my life forever,

Dx 8/12/2011, DCIS, Stage 0
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Mar 22, 2012 07:14AM SW0110 wrote:

I had my tram flap surgery in February 2011.  I too have a bulge on my left side where the muscle was removed.  My PS stated that is was caused due to weaking of the anchoring of the mesh after surgery.  The option is to live with it or surgically go back and give it more support.  In total since my diagnosis in January 2010, I have had 8 surgeries including a complete hystorectomy in December 2011.  At this time I am not mentally ready for any more.  I have been trying to lose the weight I gained during chemo and steriod treatments and of course putting my body into complete menapause.  Does anyone know how much weigth the mesh would add to my own body weight due to fluids being absorbed?

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Mar 28, 2012 07:18PM Binney4 wrote:

bdavis, have you found a lymphedema therapist to help you?

Persistent redness of the skin can also be a result of lymphedema -- the stagnant lymph fluid causes inflammation . If the lymphedema is treated it will reduce the swelling and redness and also lower your risk for serious infection.

Here's how to find a well-trained lymphedema therapist near you:
http://www.stepup-speakout.org/Finding_a_Qualified_Lymphedema_Therapist.htm

There is a forum here for Lymphedema. Please feel welcome to come join the "swell" gals there.

Be well,
Binney

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