Repair on TRAM flap

['lizbeth]

Hello all,

I was wondering if anyone else had a partial loss on their TRAM reconstruction and what your choice/ experience was in fixing it.

My plastic surgeon wants to wait 6 months after I finish my chemo before additional surgery. I'm not sure what I want to do at this point, but I wanted to start checking into my options and hear about others experiences.

Thanks,

'lizbeth
San Diego

[TriciaV]

I had double tram flap this past April. Please feel free to contact me, I would love to chat about your experience and mine.


Tricia V

[swimangel72]

Hi - my flap is OK, but my abdomen (donor site) is not. My PS wants me to wait until I'm finished with Herceptin - which means I have to wait until April '09. I went to another surgeon who is an expert in repairing abdominal bulges/hernias, and he said as long as my blood counts and Muga/echocardiogram were OK, I could have surgery (other women have told me the same thing.) However, I did have an abdominal staph infection which caused my incision to open - the new surgeon said it's important to find out if I had a MRSA infection because that would influence when and how they will repair my big bulge, sigh. I have to still find out from the hospital - but since I was on so many antibiotics, including Zyvox, he thinks I did have MRSA. I'm impatient to get my stomach fixed, because the bulge is growing - but I'd HATE to get another staph infection, so it looks like I'll be waiting until at least February. :( But the good news is that the new surgeon said he'll be able to remove my gall-bladder at the same time - and a renowned plastic surgeon will be able to fix my hamburger "foob" at the same time, so hopefully this will all have been worth while.

['lizbeth]

kathy,

I have to ask. What is a hamburger "foob"?

'lizbeth

[swimangel72]

A "foob" is a Fake Boob.....my reconstructed breast. It has no projection - sort of flat like a hamburger.....with a lot of fat under my arm. I shouldn't complain - I've had no healing problems with the foob at all, for which I'm so grateful (especially after all my problems with my stomach). The PS says he'll reshape it to fill out a bra in Stage 2 - but I'm getting a second opinion to make sure I'll be happy with the aesthetic outcome after all I went through!

['lizbeth]

"Foob" a fake boob - that is hysterical. I'm going to borrow your word.

I was wondering if I should get a second opinion. I love my current surgeon. I just wanted to make sure I'd be happy with the final results.

[TriciaV]

Swimangel and Lizbeth..... did each of you only have one breast done. Swimangel... did you say in the other thread that you had a muscle sparing surgery...if so... what tissue did they use to create a breast from?? I wish there was a way for us to share pictures for those that wanted share... I sure wouldn't mind showing my pics of all my before and afters and I would love to see others.... I have googled looking for pics of before and afters but I can't really find too many.

[swimangel72]

Tricia I had a "unilateral muscle-sparing free tram" - which means, just one side, my right side, was reconstructed immediately following a "skin-sparing mastectomy." The reconstruction involved cutting the fat and skin and perforator vessels free from the underlying muscle (sort of like a tummy-tuck) and microsurgically reconnecting the perforators (veins?) to veins in your chest to keep the flap alive. Only a small piece of muscle (1 cm) was removed with the perforators to keep them stable - but that small piece was enough to cause me a lot of problems. The best surgery to get is the Diep where NO muscle is removed at all. I had asked for that, and my PS said he'd try - but somewhere during surgery he changed his mind.

More information about reconstruction options can be found here:
http://www.breastreconstruction.org/ (http://www.breastreconstruction.org/)

And more information and support (including photos) can be found at www.breastcancer.org (http://www.breastcancer.org)

Hope this information helps you Tricia!

['lizbeth]

Tricia,

I had just the right side done. My breast surgeon did a skin sparing mastectomy. Then my plastic surgeon immediate performed pedicled flap which used the entire right rectus abdominus muscle. (I no longer have a six pack = I'm down to a 3 pack now). I would have like to have the DIEP but that option wasn't available to me at our regular hospital. After hearing from others I am fairly pleased how things turned out from the reconstruction surgery.

If you'd like a photo of my current result I'll have my hubbie take a picture and I'll email it to you in a day or so. I'm still a work in progress - my plastic surgeon hasn't finished with the right breast and he will reduce and lift the left to match.

'lizbeth

[TriciaV]

Lizbeth,

With my insurance there was only one plastic surgeon who did the diep and he was pretty much impossible to get hooked up with. I would love to see your current results. I am also a work in progress. Hopefully after this next revision I can get my nipples done also. One night my hubby had drawn on some nipples for me...LOL but it really did make them look sooo much better. At first I thought I didn't really care about nipples until he drew them on.... so I for sure want to get them done, But have to get this last surgery out of the way first.

[StillHere]

I had my bi-lat free flap done 3 yrs ago. I did have to go back for emergency surg the next day because I was loosing blood flow to the left (non-cancerous) foob (love that word). My plastic surgeon was able to save the flap. He reconnected blood flow using my mammory blood vessel. I had my port taken out at the same time as my free flaps. The port removal somehow blocked the blood flow from the initial flap surgery (Swelling?). Had to find a new route, but all ended OK. I know my surgeon would not do the free flap directly after my bi-lat mastectomy because he did not want to risk loosing the flap to radiation. I look like a patch work quilt, but am still happy I had it done. It does not show w/ a swimsuit, tank top, etc. I think if I am NED at 5 yrs, I will get 2 tattoos. One the sign for woman and on the other side a peace sign. No nipples for me.