Transverse rectus abdominis myocutaneous flap surgery, or TRAM flap surgery, is a breast reconstruction procedure in which a surgeon cuts lower abdominal tissue that contains skin, fat and muscle and transfers it onto the chest as a pedicle flap or free flap to act as a breast tissue, according to Healthline. Typically, this procedure is useful following mastectomy, which is the surgical removal of cancerous breast tissue.
Two types of TRAM flap surgery include free flap and pedicle flap, notes Healthline. While the free flap involves connecting the breast mound with the blood vessels in the chest, the latter involves leaving the attachment of the mound to the abdominal blood vessels intact. Before a surgeon performs TRAM flap surgery, he first assesses the patient's condition to determine if the procedure suits her. Patients who may not qualify for this procedure include women who have undergone previous surgeries in their abdomen, women who smoke and women who have very little tissue in their abdomen. The procedure may not suit women with diabetes or obesity.
Though beneficial, TRAM flap surgery is a risky procedure as is predisposes patients to excessive bleeding and infection, as Healthline states. It may also cause breast sensation loss due to disrupted blood supply. Pedicle TRAM flap may weaken or bulge the abdominal wall.