TRAM Flap

TRAM may be done as either a pedicle flap (which means the lower abdominal tissue remains attached to the body and is rotated under the skin to the chest area without cutting its blood supply) or a free flap (which means the lower abdominal tissue is disconnected from the body and reattached in the chest area).

Both a pedicle TRAM and a free TRAM require removal of the rectus abdominis muscle from its natural location which will result in loss of core strength. Usually a piece of synthetic mesh is required to repair the defect left after removal of the abdominal muscle, which can put patients at risk for abdominal hernias or bulges.