Advantages and disadvantages of types of reconstruction
Breast reconstruction using muscle, fat and skin flap rotation, from the back or abdomen, is a major operation and needs a hospital stay of at least one week. Using a flap from the back generally gives less risk of complications than using a flap from the abdomen but an implant is often needed. You may also experience weakness around the shoulder joint post operatively and may require physiotherapy.
The TRAM flap can only be used for women who are slim, in good health and do not smoke. After the muscle of the abdominal wall has been removed there will be some reduction in abdominal strength and often a mesh is used to reinforce the abdominal muscles to prevent hernias occuring.
The above techniques involve moderately long operations of approximately 3-4 hours and a 5-6 day stay in hospital.
The free tram flap involves taking a flap of skin, fat and some muscle with blood vessels from the abdomen, detaching the flap and reconnecting the vessels to the chest. The advantage over the pedicled TRAM is that it is a safer flap, more tissue can be used and so a larger breast can be created. It does involve microsurgery and takes longer.
All types of perforator flap reconstruction produce a very natural and permanent reconstruction. They are however unsuitable for obese patients, diabetics or smokers.
The TRAM flap can only be used for women who are slim, in good health and do not smoke. After the muscle of the abdominal wall has been removed there will be some reduction in abdominal strength and often a mesh is used to reinforce the abdominal muscles to prevent hernias occuring.
The above techniques involve moderately long operations of approximately 3-4 hours and a 5-6 day stay in hospital.
The free tram flap involves taking a flap of skin, fat and some muscle with blood vessels from the abdomen, detaching the flap and reconnecting the vessels to the chest. The advantage over the pedicled TRAM is that it is a safer flap, more tissue can be used and so a larger breast can be created. It does involve microsurgery and takes longer.
All types of perforator flap reconstruction produce a very natural and permanent reconstruction. They are however unsuitable for obese patients, diabetics or smokers.
