Overview
What is unipedicled TRAM breast reconstruction?
When is a unipedicled TRAM breast reconstruction procedure indicated?
How does a unipedicled TRAM breast reconstruction affect future pregnancies?
Workup
Treatment
What are the stages of unipedicled TRAM breast reconstruction?
What is included in patient education about unipedicled TRAM breast reconstruction?
What is included in preoperative care for a unipedicled TRAM breast reconstruction procedure?
How is a unipedicled TRAM breast reconstruction procedure performed?
What is included in postoperative care following a unipedicled TRAM breast reconstruction procedure?
What are the possible complications of a unipedicled TRAM breast reconstruction procedure?
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Blood supply to the unipedicled transverse rectus abdominis myocutaneous (TRAM) flap. Note the superior epigastric supply and the shaded area of the TRAM flap to be discarded.
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Patient 1: The small-breasted patient did not want contralateral augmentation, and it would be difficult to match her breasts with an implant alone.
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Patient 1: Postoperative view after unipedicled transverse rectus abdominis myocutaneous flap reconstruction. This small breast with ptosis would be impossible to achieve with an implant.
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Patient 2: A full C cup breast and an ample abdomen for an unipedicled transverse rectus abdominis myocutaneous reconstruction
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Patient 2: Postoperatively after unipedicled transverse rectus abdominis myocutaneous and nipple reconstruction. Note the improvement in the patient's abdominal appearance, a benefit of this type of reconstruction. She has been encouraged to return for re-application of the removed portion of her tattoo.
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Patient 3: The patient's right lateral scar during initial biopsy precludes a true skin-sparing approach. With ample abdominal tissue, she is an excellent candidate for unipedicled transverse rectus abdominis myocutaneous reconstruction.
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Patient 3: Postoperative view after unipedicled transverse rectus abdominis myocutaneous flap reconstruction. Note the abdominal skin replacing the removed skin to maintain breast shape. The patient does not desire nipple reconstruction.