Muscle-sparing TRAM flapCase ID: 0938
Front: 61 year old 5 foot 5 inch 148 lb female who previously had left mastectomy and needed radiation to the left chest wall. As a result she had left arm lymphedema and severe tightness across the chest wall. Note hyperpigmentation of radiated skin.
Left: Because of the radiation, this patient was not a good candidate for implants. With lymphedema, the latissimus dorsi flap was not a good option.
Oblique Left: To get as much abdominal tissue for reconstruction as possible, a muscle-sparing TRAM was performed, preserving more perforators and blood supply than could be achieved with a DIEP flap in this thin patient.
Right: To get symmetry with her native right side, a mastopexy (lift) was performed.
Oblique Right: Nipple reconstructed but not yet tattooed. Pictures 2 years after flap and 9 months after the nipple reconstruction.