Breast Reconstruction by Tram Flap Cases

This case shows a patient who is undergoing the process of breast reconstruction. She is shown before nipple reconstruction and after nipple reconstruction. The subtle increase in volume overall in the post-op view (arrows) comes from fat grafting done at the time of nipple reconstruction.

This patient underwent bilateral mastectomy and bilateral reconstruction with pedicle TRAM flaps. Later, nipple reconstruction and fat grafting added to the transformation. An exceptional outcome in breast and abdomen.

This patient presented with left breast cancer and after a lumpectomy had a significant defect and asymmetry.  She underwent a left mastectomy and I did a TRAM flap reconstruction with a right breast lift.  Now her breast is much more symmetric.

TRAM flap plus implants is a complex combination procedure few surgeons will perform. Here, this patient is shown after successful reconstruction after a bilateral mastectomy.

This case shows a patient after TRAM flap breast reconstruction for left mastectomy and post-surgery radiation. She developed severe radiation-induced atrophy and contracture.

I released the scars with micro-release, non-incisional techniques and fat grafting. She is shown with dramatic improvement. A fine outcome.

This young patient is shown in the top row of photos prior to a left total mastectomy for breast cancer and in the bottom row of the photographs after a left mastectomy, TRAM flap with implant under flap left breast reconstruction and right breast augmentation for symmetry. An outstanding cosmetic outcome with a noticeably slimmer abdomen, fuller breast, and near duplication of the right enhanced breast on the left side. Small B to Full C cup transformation.

This woman faced a decision regarding management of her breast cancer. She was planning a bilateral mastectomy. She had enough tissue in her abdomen for use in immediate reconstruction. Several months later a minor procedure to make the nipples completed her reconstruction. Her abdomen is flat. She looks great and feels complete after her mastectomy. An ideal outcome.

This patient is shown in the top row of photos just prior to undergoing a right mastectomy for breast cancer. The bottom row shows her after the mastectomy, tram flap reconstruction of the former right breast site, nipple reconstruction, and left breast mastopexy (lift) for symmetry.

Note that the new nipple (right breast) closely resembles the left nipple (her own natural nipple).

This case follows the course of a woman who presented me with the bilateral absence of breasts after a double mastectomy. Her deformity (typical) can be quite challenging. A bilateral Tram Flap with implants (a difficult combo few plastic surgeons will do) gives her a fine outcome. She is shown in the various stages of recovery.

This woman presented with a plan to undergo a right mastectomy for breast cancer (multifocal). A tram flap was done to reconstruct her right breast immediately.

She is shown in the left column of two photos before the mastectomy.  The middle row of photos is after the initial tram flap. In the right column, two photos are after the nipple reconstruction and the pigmentation.

Note the natural, aesthetic outcome here. Remember this was a mastectomy for breast cancer, but you can’t tell that at all.