Natural Tissue Flap Reconstruction

Recovery after DIEP flap surgery can take anywhere from six to eight weeks.

A TRAM flap does not disconnect the vital blood vessels needed to keep the tissue alive during the transfer process, whereas a DIEP flap carefully dissects them to be re-attached in the chest cavity.

DIEP stands for deep inferior epigastric perforator artery, which is the main artery used to control the blood supply to the chosen tissue.

It will take 6-8 weeks to recover from TRAM flap surgery. At one month after surgery, most patients start to feel back to normal. Return to routine exercise and weight training will depend on what your surgeon recommends, but most patients can expect to return to these activities by 2-3 months after surgery.

The rectus abdominis muscle is taken with, fat, skin, and blood vessels and this is rotated under the skin from your abdominal wall to your chest. The tissue will then be used to shape a breast mound on the chest.

Full recovery after a pedicled TRAM flap takes about 6-8 weeks. You will be monitored in the hospital for about 1-2 days, and encouraged to walk daily. You will have drains, and these are removed within the first 2 weeks of surgery. There will be some soreness and discomfort, which is managed with pain medication. Most patients begin to feel like normal at 4 weeks after surgery, and can resume normal unrestricted exercise by 2 months.

Since a pedicled TRAM flap falls under the category of breast reconstructive surgery, your insurance will likely cover some portion of the procedure costs.

Since more muscle is used, making this a larger procedure, there may be a bit more pain than after your mastectomy. The first few days after your procedure will likely be the most uncomfortable and it may continue to be painful when you sit down or get up from a sitting position. If the pain is severe, contact your doctor to discuss pain medications or use over-the-counter medications.

An incision will be made along the bikini line, leaving a long, thin scar from hip to hip.

A free TRAM flap may involve one or multiple surgeries depending on the ultimate goal of the patient. The initial surgery is the most involved as it takes between 6-8 hours and requires a few days of inpatient recovery. After 3 months of healing from the initial surgery, you will be able to undergo any additional outpatient procedures to add the finishing touches on the reconstructive result such as contouring of the breast mound and nipple reconstruction.

There will be some soreness and discomfort in the initial few weeks after surgery, which is easily managed with pain medication. You will also be required to modify the way to you sleep and walk for about 1-2 weeks to protect the incisions while they are healing.

Since free TRAM flap is a breast reconstruction surgery, your insurance should cover some portion of the costs.

A free TRAM flap take the entire rectus abdominis muscle along with the overlying fat, skin, and blood vessels, which are transplanted to the chest to rebuild a breast mound. This surgery uses the entire rectus muscle compared to a DIEP flap which spares the muscle. The blood vessels will be carefully reattached to blood vessels in your chest, and this is considered a tissue transplant.

After your free TRAM flap, you will be admitted to Full recovery after a free TRAM flap takes about 6-8 weeks. You will be monitored in the hospital for about 1-2 days, and encouraged to walk daily. You will have drains, and these are removed within the first 2 weeks of surgery. There will be some soreness and discomfort, which is managed with pain medication. Most patients begin to feel like normal at 4 weeks after surgery, and can resume normal unrestricted exercise by 2 months. hospital for about five days to be carefully monitored. Your full recovery will take an additional 6-8 weeks.

A SIEA flap procedure, is similar to a DIEP flap procedure, except that a different blood vessel is used (superficial inferior epigastric artery) and no muscle is taken. The abdominal incision is made along the bikini line to remove fat, skin, and blood vessels from the abdomen, which are then reattached to the chest to create a breast mound.

You may be a good candidate for a SIEA flap if you have never had previous major surgery on your abdomen and have enough tissues in your lower abdomen to create a breast.

Both the free and pedicled TRAM flap procedures use skin, fat, blood vessels, and the entire abdominal muscle to reconstruct the breast. This causes abdominal wall weakness over time, due to removal of the rectus abdominis muscles. A DIEP flap spares the rectus abdominis muscle and only takes skin, fat and the deep inferior epigastric artery and vein. A SIEA flap takes the skin, fat and superficial inferior epigastric vessels, which does not require any incisions to be made along the abdominal wall fascia.

The main benefit of an SIEA flap is that an incision can be avoided on the abdominal wall fascia, and no recuts abdominis muscle is taken.

A thigh flap involves removing is a section of skin, tissue, and blood vessels from the front or back of the thigh. Patients who have excess medial thigh tissue or posterior thigh tissue may be candidates for this procedure.

A TUG flap, also called transverse upper gracilis flap, involves taking skin, fat, and a small amount of muscle from the inner thigh to create a breast mound.

TUG, VUG, and DUG flaps all take a flap of tissue from the thigh. The main different is in the scar placement: a TUG flap will leave a scar going across the thigh, a VUG flap leaves a scar going down, and the DUG flap scar runs diagonally in the inner thigh. A gluteal-based flap takes skin and fat from the buttocks, and this can be an option for women who have excess tissue in these areas.