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Topic: Question about abdominal exercises after a tram flap

Forum: Fitness and Getting Back in Shape — Conversations about exercise, diet, and getting back in shape after breast cancer diagnosis and treatment.

Posted on: Apr 22, 2008 06:51PM

mtriso wrote:

Does any one know if doing abdominal exercises like crunches, etc makes the breast from a tram flap harder? I had a tram flap after my mastectomy 7 years ago and for several years the tram breast was always very hard, never soft feeling. About 2 years ago it soften up, around the time that stress in my life caused me to stop exercising. Now, I am back to exercising on a regular basis and have started doing abdominal exercises for the first time ever and now I am wondering if it will cause the breast to get hard. That breast has also gotten smaller than the non cancer breast and I wonder if it will grow from the abdominal exercises. I feel like I am rambling so I hope this is understandable. Any one have any ideas on this? Thanks.

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May 18, 2008 09:09PM lockerbie2 wrote:

I had a double tram flap and i am having a heck of a timewith my stomach!!! It bloats and i feel like i am going to burst! also i can't  move quickly (normal reflexes) without having pain, i can't do a sit up. and  i ache in the bottom of my stomach.  Did something like this happen to you? is it normal?

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May 18, 2008 09:25PM swimangel72 wrote:

Hi Mtriso - Did you have a "free-tram" ? If so, you should be fine doing abdominal exercises.....they should have no impact on the hardness of your new breast. Your new breast should stay soft - the hardness you experienced before was no doubt due to the newness of the procedure and possibly due to swelling. But since I haven't done any abdominal exercises myself yet after m March 3rd Diep, I can't really give you advice - who knows what will happen to my new "foob" when I start trying to get back in shape?

Lockerbie2 - your screenname conjurs up a sad time for me when my husband's close friend died in that awful terrorist attack on the plane over Lockerbie - is that what your name refers to? To answer your question - the same thing happened to me - the bloating - the pain - and my Diep surgery was nearly 3 months ago. How long ago did you have your surgery? And again - was yours a "free-tram" - that is, a "muscle-sparing tram"? If not, then you may not be able to do a sit-up ever again without the aid of a physical therapist (this according to a friend of mine who had her surgery about 10 years ago.) My own bloating is due to abdominal lymphema and I'm been going to an LE therapist who performs massage therapy on the abdomen and arm. It helps - a little bit - but I find if I'm too active during the day, my tummy gets even more bloated at night. I'm told it WILL get better over time - so I'm hoping the same will be true for you! Be sure to talk to your surgeon about your problems and ask him if he thinks a lymphedma therapist could help you. 

3/3/08 Right-side mastectomy with immediate muscle-sparing free tram; 3/9/08 Developed abdominal MRSA staph infection and hernia;Completed 4 months Navelbine and 1 year Herceptin; Arimidex - 3 more years! Diagnosed at age 53 Dx 2/5/2008, IDC, <1cm, Stage IB, Grade 1, 0/7 nodes, ER+/PR+, HER2+
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May 26, 2008 07:10PM bean2649 wrote:

Hi, I'm new. I stumbled on this site looking for answers about abdominal swelling after a Tram flap. I had a mastectomy and tramflap on February 12. Sometimes, my abdomen feels like it's stretched tight and bloated. It does seem to worsen when I am active. Everyone says it can take months and to be patient.

I'm concerned due to the difference between when I'm inactive and when I'm active. I have CFS so my active isn't all that active.

Do any of you were a compression garment? My surgeon suggested one and I have tried many different ones. Should I wear it all the time? What kind is best?

Any info would be much appreciated.

Believe Dx 12/17/2007, DCIS, 1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR-, HER2-
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May 27, 2008 07:35AM FitChik wrote:

bean...You might want to repeat this question up in the surgery or recon sections where more women hang out and are more likely to have had the same issue.


"Above all, be the heroine of your life, not the victim." ~Nora Ephron
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Jun 19, 2008 12:54PM Pharmmom wrote:


I had the tram and was told no sit ups etc.  I had a hernia too.  I feel like my sides are deflating!!!!  Love handles.  :) LOL.  I spoke to the doctor and he said there was not much I could do with abdominal exercises.  I have gained about 8 pounds and its depressing me! 

Dx 10/11/2002, IDC, 1cm, Stage IIA, Grade 3, 3/17 nodes, ER+, HER2+
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Jul 15, 2008 12:35PM Scottie1958 wrote:

I to am having problems with stomach/upper abdomen bloating after DIEP surgery.  I did not know, until today, that I was not suppose to do exercises (especially sit-ups) until 6 months after my surgery.  Now I'm wondering if I made a small issue into a mountain.  I've stopped with the exercising, but I too have gained weight as I have to take Femara for the next five years.  I am very unhappy about the weight gain.  Thought about trying to get LapBand surgery to keep the weight gain down, but the 2/3d stage of my reconstructive breast surgery is due next Monday.  I will have to delay consulting with a gastroenterologist until later.  If anyone has an alternative to the bloated stomach, please share.

Thank you

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Jul 15, 2008 12:39PM Scottie1958 wrote:

Wow, I already feel better just reading the messages here.  At one point, I thought I was truly going to become the freak of nature.  To have a nice, flat lower abdomen, but the bulging top portion is driving me crazy.  I have to keep pulling the top part of my pants or it rolls down.  It's embarrasing at times.  I will speak with my surgery about it this week.  Any news I get, I will come back and share with you all.

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Jul 15, 2008 06:06PM - edited Jul 15, 2008 06:29PM by RRR

I am about three months post TRAM surgery.  I am lumpy and bumpy in some areas around my breasts but my PS said he would remove much of that and even things out in stage 2 so I am not worried about that.  I had been exercising on an indoor bike and really watching my diet, keeping it bland.  I was really pleased with some semblance of a shape returning  and I had lost about 14 lbs after surgery.  Fast forward a couple of weeks and now my family is visiting.  Bunch of eaters, we have been eating out, BBQ'ing, having snacks, drinks, appetizers, etc.  I went back to the bloated upper belly with the funky detached feeling in my gut that I started out with.  I think my midsection looks like a frog belly right before dissection (a vision that keeps the sprinkles off my ice cream).  I haven't really gone overboard on eating.  I just need to face facts that I can't have salty food, spicy sauces, carbonated drinks, processed foods, bacon or anything that will cause bloat because right now it will just go to extremes. I have since upped my water intake, started eating better, cut out soda, and tossed all the fun food except the bag of Hershey kisses (they don't go bad).  Already I can feel things deflating.

Just noticed my recent default photo was taken at Chili's.

Dx 7/5/2007, IDC, 3cm, Stage IIB, Grade 3, 1/25 nodes, ER-/PR-, HER2-
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Sep 10, 2008 07:19AM - edited Sep 10, 2008 07:20AM by Scottie1958

This Post was deleted by Scottie1958.
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Oct 27, 2008 10:12PM Tigwin wrote:

I had my tram on August 25th.  I was told no exercise what so ever for three solid months.  I  will see my surgeon in November to find our what I can do besides walk.  I have lost 15lbs since the surgery but i had a hysterectomy as well.  I tried to do a sit up yesterday just to try and i could do it but I only did three and quit.  I think we all have to realize this is a long haul and we have to be paitent.  I think this is the hardes thing for me.  My brain is alive and wanting to go but my body is not there yet. 

One thing my surgeon explained to me was your stomach is tighter which will not allow you to eat as much as you would normally.  I cannot eat the same amount I use to without rushing to the bathroom.  Sorry to share that but it really has been the hardest part for me. I have to eat very small meals slowly to have it digest well. 

Hang in there...we will get through this.

Dx 2/28/2008, IDC, Stage II, 0/1 nodes, ER+/PR+, HER2- Dx 11/12/2015, Both breasts, Stage IV, metastasized to bone
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Nov 26, 2008 09:19AM sccruiser wrote:

I had a TRAMflap recon on right breast. Ended up with truncal Lymphedema. I fluctuate about 5-8 lbs in weight on a daily basis--sometimes w/in hours. Water aerobics has been my exercise choice, and it has kept me sane and my belly flat. I highly recommend it. There are exercises you can do in the water that mimic crunches, and I am slowly getting stronger belly muscles--but they will never be what they were before bc surgeries.

Give the water a try--I go at least 5 days a week! Have just switched to a deep water aerobic class, and dropped 3 lbs the first day. I will begin doing that 3 days a week in January, plus continue my lap swimming (1/2 mile right now) 2 days a week.

You can always get a referral from your doc to see a Lymphedema specialist. A LANA certified therapist can help you determine if you have lymphedema or not. I do, so have prescribed special compression garments I wear daytime and nighttime. I see the therapist every 6 months as needed for measurements and new garments.

One must still have chaos in oneself to give birth to a dancing star
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Aug 6, 2009 06:27AM sarjie5 wrote:

Hi I am new to this forum.  I had a tram flap reconstruction on May 26 2009.  Since then I have suffered from the bloating.  what I do notice is that it goes away when I do light exericise such as walking and when I watch what I eat, particularly avoiding coffee and salty foods.  Hope this helps.

Dx 12/29/2008, DCIS, Stage 0, Grade 3, 0/0 nodes, ER+, HER2-
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Sep 18, 2009 08:41PM - edited Sep 18, 2009 08:46PM by bettysoo620

I had a free tram flap on Sept 16 2008, I am having the same problems, I am 131 lbs, I get bloated if I eat a slice of melon, also my pants cannot stay up on my waist what do you suggest


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Sep 18, 2009 10:08PM - edited Sep 18, 2009 10:10PM by smithlme

I had a failed TRAM in January of 2008 and I still get bloated every day. By the end of the day I look and feel terrible. The bottom of my stomach is nicely shaped but the top bloats sideways. On October 14 I am having scar revision surgery to get rid of the dog ears on my sides and to flatten out the skin sparing mastectomy mess on my right side and smooth out the left side. If I'm going to be flat I want it to look as good as possible...


Edited to add that Yoga has been the best "exercise" for me. My core is much stronger.

Dx 3/31/08, DCIS, ER+/PR- BRCA2+...I am NOT a survivor...I am a 2X breast cancer A$$ kicker! Dx 3/28/2007, IDC, 2cm, Stage II, Grade 3, 0/9 nodes, ER-/PR-, HER2-
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Sep 30, 2009 06:31PM bettysoo620 wrote:

I am having the same problems with my pants, pretty soon I will have to wear suspenders, every where I go I have to keep pulling up my pants, is ther something we can do about this, I am 130 lbs, also my stomach is so so lopsided, I am really depressed about it, I am actually sorry I did it, so confused. 


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Oct 6, 2009 11:02AM - edited Oct 6, 2009 11:03AM by bettysoo620

I feel the same way, so depressing I am so lopsided, also I can't wear thight clothing, my scar across my tummy itiches like crazy, does this happen to all who had the free tram flap?

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Oct 26, 2009 07:52AM franee137 wrote:

WOW!..I thought I was well past shedding any tears over my breast cancer experiences. I was 34years old when I was diagnosed with IDCS. I just passed the 10 year mark. But after reading this blog..I am sitting here in tears. I had tram flap surgery back when no one knew what it was. I also had the complication of a seroma, right in the middle of my stomach right after the surgery. Basically it was a LARGE pocket of fluid that kept filling up and wouldnt heal. As a result of this I needed to have a drain put back in 3 mos. after my original surgery, leaving me with a vertical scar, about 6 inches long from my belly button up. Until today this area is still tender, it bulges, it aches, and it makes finding a pair of jeans, that fit comfortably damn near impossible.I have also had a few other procedues done laproscopically. The last doctor told me that the scar tissue in that area is so thick he almost couldnt get through it. I thought I was the only one who's pants didnt fit right and had to keep yanking them back up! It doesnt make my jeans fit any better but it helps to know I am in good company!

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Oct 27, 2009 03:48PM sandy2009 wrote:

Hi, I had a DIEP surgery that turned into a ped. tram on 2/25/2009.  I was bloated for months and worried a lot about it.  I went to an occupational therapist for arm exercises to begin with, then eventually for my core muscle/stomach.   I went from May-Sept twice a week.   I stopped going when I finally could do a sit up!   I said "if I can do this, I WANT to do it!"    With help, and holding my feet down I eventually purservered and did a sit up, then 5 and eventually 5 more. Trust me, this was not easy.   

I want to eventually do a sit up without help, I believe it's possible but you need good help and coaching.

Dx 11/10/2008, ILC, 6cm+, Stage IIB, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Dec 22, 2010 08:30AM keela50 wrote:

I had the same Tram Flap surgery in 2007. I have a huge , lopsided tummy bulge, can't wear close fitting clothes, feel bloated and uncomfortable all the time. I also gained weight. I am very disappointed and unhappy. I would not do this if I had knowledge of the after effects.  Also the tissue on the reconstructed breast spreads . My PS advises lipo.


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Jan 13, 2011 11:31AM Ellie1959 wrote:

I had a tram-flap done in 2007 - and I have the chubbiness hanging over the sides but no fat rolls on my stomach. I was told that since your six pack is cut you can't do sit-ups. I can't even sit up without using my ams or my back. God help me if I try to get out of a pool or pull myself up. It's been over 3 years and I've adapted but I would like to do ab exercises if I could. I have problems toning my arms too because my pec's are gone - any suggestions for this?

Dx 12/27/2005, ILC, 5cm, Stage IIIA, Grade 3, 2/12 nodes, ER+, HER2-
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Feb 28, 2011 06:56PM thoughts5000 wrote:

Yoga really helped me. Start with a restorative yoga class. My oblique muscles are much stronger and I am getting my shape back. Sit ups that focus on the missing rectus abdominus won't do anything. Yoga really helps with the arms as well. And it does wonders with improving my attitude. Mind and body!

Dx 6/2008, <1cm, Stage I, ER-/PR-, HER2-
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Apr 19, 2011 03:13PM - edited Apr 19, 2011 03:14PM by betsybug

i need some help please......my tram flap "failed" when i had my bi-lateral mastectomy.  this means that i had to have 7 reconstructive surgeries for breasts and basically had a tummy tuck..... i couldn't get a lot of explanation from my PS and he has retired now.  my question is CAN I DO ZUMBA AND YOGA EXERCISES THAT WORK ON THE ABDOMINAL MUSCLES????  from what i can remember, they cut all the muscles in my stomach!!!  when i joined the YMCA they were trying to establish a workout program for me and when the instructor found out about my surgeries she suggested that i walk and do water aerobics.......my surgeries were 11 years ago this september.  

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Apr 23, 2011 10:18AM - edited Apr 23, 2011 10:18AM by karenmarie1

I had a tram in 2002. So confused about the right name for it, but it was the one where they take ab muscle and tunnel under to create the breast. As far as the appearence goes, I have been really lucky! Breast looks good, abs look great! As far as recovery went, it was easy (I was 42). I never used the walker they gave me, I was moving around in two weeks and back to work full-time in a month. Long term effects suck........  pain pain pain. Back pain like you would not believe and sadly, I have been taking narcotics for 4 years to cope with this and be able to continue with my daily life. Yoga works wonders and I would highly recommed for all ladies with reconstruction. The gentle stretching is great for the body and necessary for your well being. (((hugs)))

Karen Marie Orig DX 2/2001,IDC, 5cm, Stage IIb, Grade 2, 0/7 nodes, A/C 6 rounds, CHF Due to Chemo, 7/2005, Recurrence, 1/26/2010, Recurrence 11/2012 Stage IV, Taxol 11/2012, ER+/PR+, HER2-
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Apr 23, 2011 10:33AM Snobird wrote:

Wether a TRAM or DIEP it is your belly fat that is used as the breast tissue. When you gain or lose weight it will happen in the fat tissue in the breast and anywhere else that you have fat tissue like above the abdomen scar. Your new flat belly lacks the fat tissue as it has been relocated. If you gain a lot of weight you will still have a fairly flat tummy but your upper abs and hips will grow bigger as will your breasts. Crunches will not help. Walking, running, any aerobic activity and a good nutritional lifestyle (I hate to say diet because that seems temporary and this needs to be permanent) will help. I tell myself that food is medicine because I'm not on chemo and it wasn't recommended for me so this is my way of fighting the disease.

Dx 10/2006, Paget's, <1cm, Stage 0, Grade 3, 0/7 nodes, ER+/PR-, HER2+ Surgery 12/20/2006 Lumpectomy: Left Surgery 2/15/2007 Lumpectomy: Left Radiation Therapy 3/7/2007 Surgery 12/6/2010 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Surgery 11/17/2011 Reconstruction (left): Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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May 17, 2011 06:23PM - edited May 17, 2011 06:24PM by pinkribbons2

I had a tram flap in February 2010.  I have been in constant pain since that day.  I regularly feel what I compare to contractions during labor.  Stretching over my head is practically unbearable.  I can walk for a good distance, but if I walk up stairs or do any type of lifting I'm completely worn out.  I also can't find pants or jeans that fit.  They say hindsight is 20/20; if I knew then what I know now about the tram flap, I NEVER would have had it.  I had originally said I wanted the bilateral mastectomy and no reconstruction.  My PS convinced me that I would have 'body image issues'. He told me I couldn't do sit ups again and that the recovery would be 8-12 weeks.  I'm now 15 months out and still in constant pain.  I'd like to become more active again, but any type of exertion completely wears me out.  I guess I'll keep on walking and I'm thinking after reading these posts that yoga and water aerobics may be good.  Thanks for the good advice. 

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May 24, 2011 01:51PM Wilza1 wrote:

I had tram flap in January 2010 - I find water exercise helpful. Trying to go to pool every day for at least 30 minutes. My problem is a fairly new one....I am experiencing bloating. It doesn't seem to matter what I eat or if I eat. Tummy is full & hard!!! Any ideas? I can't say I have pain, just discomfort.

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Jun 21, 2011 09:29AM thoughts5000 wrote:

I had bloating problems as well. I think all the antibiotics I took while healing upset the balance of good and bad bacteria in my digestive system. My gastro finally gave me xifaxan for three days; then I started  florastor (OTC) every day. It really helped.

I will also say that sometimes my obliques get fatigued out after a workout or too much standing; and I can longer hold my muscles tight and get that tight, bloated look.

Dx 6/2008, <1cm, Stage I, ER-/PR-, HER2-

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