Are you a cancer victim? Have you suffered a debilitating disfigurement due to a mastectomy? Are you ready for breast reconstruction to restore your dignity?
Breast reconstruction is primarily for patients who have had a mastectomy secondary to breast disease or breast cancer. The breast tissues and nipples are excised by the general surgeon. The plastic surgeon then would perform breast reconstruction to help recreate a breast mound to achieve a natural looking breast.
This process will require appreciative communication between the breast surgeon and plastic surgeon. Reconstructive options may be a tissue expansion followed by implants placement, a TRAM FLAP (Transverse Rectus Abdominus Myodutaneous Flap Latissimus Muscle, or an Implants Free tissue transfer.
Schedule Your Breast Reconstruction Consultation With Dr. Vu Today By Calling 503.601.2910 or Toll Free 866.297.8522.
This is a procedure covered by CosmetAssure. Learn how Dr. Vu protects you from any potential financial burden from complications by visiting our Complications Assurance page.
Who Is A Trim Flap Candidate?
If you have loss of breast tissue and skin following mastectomy — one or both sides. If you have loss of breast tissue only following subcutaneous mastectomy If you have a desire for larger breasts (uncommon).
Reconstruction of a missing breast(s) or replacement of breast tissue.
A flap of lower abdominal wall fat, muscle (and usually skin), is transferred to the area of missing breast tissue with its own blood supply. In a standard TRAM Flap, the blood supply is within the rectus muscle(s) which is left attached at the lower edge of the rib cage. In a Free TRAM, the blood vessels are reconnected to vessels in the axilla. In a Turbocharged TRAM, the muscle is left attached superiorly, but the inferior vessels are connected in the axilla creating a double blood supply. The abdominal donor site is closed as in a Tummy Tuck, leaving a horizontal scar and a tighter abdomen. An attempt is made to create a “normal” breast mound and shape at the first operation, but subsequent smaller procedures are frequently necessary. Nipple/areolar reconstruction is performed at a later date and is elective.
Recovery and Healing
A TRAM Flap Breast Reconstruction is a major procedure performed in the hospital and requiring at least several days of hospitalization. Ambulation will begin the day after surgery and be reasonably comfortable within 10-14 days. Complete recovery usually takes about 6 weeks. The abdominal donor site causes the most discomfort during healing.
Additional procedures that will enhance the result are enlargement, lifting, or reduction of the opposite breast, and nipple/areolar reconstruction.
Almost always covered by insurance.
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.
Special attentions are placed during your postoperative period. My goal is to make sure that you are comfortable after you leave the surgery center, and have proper instructions how to take care of yourself in order for you to have a pleasant surgical experience.
Because elevation of the TRAM Flap involves removal of abdominal skin, fat and muscle, you will experience some difficulty standing up straight for 2 or more weeks.
During this period you may find it more comfortable to place a pillow under your knees while in bed. The tightness will gradually disappear as you heal and progressively use your body muscles for the activities of daily living. Please make no special attempts to stretch or pull the abdomen straight during the first two or three weeks of healing.
During the postoperative period, avoid heavy pressure to the reconstructed breast.
You will experience some pain for 10-20 days and will not feel like resuming sports or heavy exercise for at least 6 weeks. After the first two weeks you may resume moderate walks. Too much initial activity can prolong swelling and healing.
C. Use of ice packs
Cold or ice packs help to reduce swelling, bruising and pain. Use frozen peas in a soft pack or crushed ice cubes in a zip-lock bag. If the cold is too uncomfortable, reduce applications.
Your incision lines will probably be covered with Steri Strips or tape. You will probably have an elastic abdominal binder to provide gentle pressure, to give you stability and to reduce swelling. If it feels too tight or causes pain, take it off. We do not want the binder to interfere with circulation to the skin which could cause blistering or skin loss!
The binder can be removed temporarily for laundering.
E. Showering and Bathing
You may shower even though drains are still in place. Water and soap will not hurt your incision lines. If you are weak or slightly unstable, we suggest you sit on a stool in the shower and have someone nearby in case you need help.
F. Drains and drain care
Dr. Vu will probably place drains into the abdominal surgical area at the time of surgery. Secure the bulb of the drain to your clothing or abdominal binder with a safety pin. Whenever the bulb fills or expands to 50% or more, empty the bulb by opening the plug at the top, and pour out the fluid contents.
Do not attempt to remove the bulb from the tubing. Squeeze the bulb to re-compress it and put the plug back into the hole at the top in order to maintain the vacuum. If the bulb fills rapidly after emptying it, or you need to empty it more than 3 times a day, please call the office.
G. Sun exposure
We recommend that you protect your scars from the sun for a year after surgery. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sun block with an SPF of at least 15 when out in sunny weather.