Flap Reconstructions

TRAM Flap

Donor Site: Abdomen

The most common method of tissue reconstruction is the pedicled transverse rectus abdominus myocutaneous (TRAM) flap. In this approach, abdominal muscle, tissue, skin, and fat are used to create breast shape.

The patient will have the benefit of a flatter looking abdomen. The scar on the abdomen is low and extends from hip to hip.

In TRAM flap reconstructions, patients can expect the following to occur with some
exceptions:

  • Hospital Stay: 2 - 5 days
  • Recovery Time: Several weeks to several months

Abdominal free flap

Donor Site: Abdomen

These microsurgical (DIEP, SIEP) procedures may or may not use the actual abdominal muscle, so they may allow for results with fewer donor site complications. However, they are lengthier procedures and have the potential for other complications.

These procedures should only be performed by plastic surgeons who perform microsurgery regularly and in institutions with experience in monitoring these flaps.

In free flap reconstructions, patients can expect the following to occur with some exceptions:

  • Hospital Stay: 3 - 5 days
  • Recovery Time: Several weeks to several months

LDP Flap

Donor Site: Back

The latissimus dorsi (LD) flap is most commonly combined with an implant. At the time
of breast reconstruction, the muscle flap, with or without attached skin, is removed from the back and implanted in the breast.

This flap provides a source of soft tissue that can help create a more natural looking breast shape compared to an implant alone. The scar on the back can often be concealed under a bra strap.

In LD flap reconstructions, patients can expect the following to occur with some exceptions:

  • Hospital Stay: 1 - 3 days
  • Recovery Time: Several weeks

GAP Flap

Donor Site: Buttock

The gluteal artery perforator (GAP) free flap uses skin and fat from the buttocks. This type of reconstruction is technically more difficult to perform than other procedures. Also, the tissue from the buttock is somewhat harder to shape into a breast.

In GAP free flap reconstructions, patients can expect the following to occur with some
exceptions:

  • Hospital Stay: 3 - 5 days
  • Recovery Time: Several weeks

Inner Thigh Free Flap

Donor Site: Thigh

This procedure uses skin, fat, and muscle from the inner portion of the upper thigh to reconstruct the breast. The tissue is dissected from the inner thigh and transplanted to
the chest where it is reattached using microsurgery. The resulting thigh scar is generally well hidden.

In thigh free flap reconstructions, patients can expect the following to occur with some exceptions:

  • Hospital Stay: 3 - 5 days
  • Recovery Time: Several weeks