DIEP - TRAM Reconstruction

This procedure involves moving tissue from the lower tummy to the chest, replacing the part of the breast that has been removed. A combination of skin, fat (DIEP), and sometimes a small piece of muscle (TRAM) are used. The tissue removed in this operation is the same that is excised during a tummy tuck (abdominoplasty) so in order to have this type of reconstruction, you need to have some excess tissue or fat on your lower abdomen.

Postoperative period

After the procedure, the patient awakes with dressings over the breast and tummy and will have some surgical drains in place. The abdomen will feel quite tight for the first few weeks and the first two or three days consist of bed rest with some increase in activity after that. The total stay tends to be five to seven days. A sports bra (no wires) should be worn 24/7 for four weeks together with a pressure garment for the abdomen.

What you need to be aware of

There are pros and cons for DIEP/TRAM reconstruction:

Pros:

• The new breast will change weight, and therefore size and shape, as your weight changes, resulting in continued symmetry.
• It will move and feel like your other breast.
• The shape and "hang" of the new breast achieved with this technique is excellent.
• It gives you a tummy tuck

Cons:

• It is a longer procedure (6 to 8 hours)
• The hospital stay is about 7 days.
• The time to full recovery varies between patients but it can be from 3 to 6 months.

As with any surgical procedure, there can occasionally be complications; scarring, bleeding, infection, breast asymmetry, wound breakdown, seroma, flap failure in 5 % of cases, altered sensation, lumpiness in your new breast, tummy weakness, chest infections, clots in your legs and chest. The chances of any complication can be reduced by observing the postoperative recommendations above. Smoking is also a risk factor. This subject is always fully discussed during your initial consultation.

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