Healty | TRAM Flap vs DIEP Flap: What's the Difference?

Up until a few years ago, the TRAM flap was the golden measure inwards pectus reconstruction afterward mastectomy. The TRAM has straight off been surpassed past times the DIEP flap for that honor. For patient's researching their reconstructive options afterward mastectomy, it is of import to sympathize the concept of TRAM surgery as well as how it has evolved into today's cutting border DIEP procedure.

There are 3 primary forms of the TRAM flap operation ordinarily performed past times plastic surgeons:

1) The Pedicled TRAM flap: this was the showtime functioning to depict purpose of ane of the rectus abdominus muscles (sit-up muscle) for pectus reconstruction. The surgery begins alongside an incision from hip to hip. Then, the lower abdominal tissue below the belly push (skin, fatty as well as ane of the abdominal muscles) is tunneled nether the upper abdominal peel to the pectus to practice a novel breast.

Recovery from the surgery tin live hard as well as painful. Long-term, the patient has to adjust to the loss of some abdominal forcefulness (up to 20%). As alongside whatsoever surgical physical care for at that topographic point is the possibility of complications. These include delayed healing, fatty necrosis (part of the tissue turns hard due to pitiable blood supply), abdominal complications such equally bulging and/or hernia, as well as loss of the reconstruction altogether (rare).

2) The Free TRAM flap: this physical care for uses the same abdominal tissue equally the pedicled TRAM except that the tissue ("flap") is disconnected from the patient's body, transplanted to the chest, as well as reconnected to the trunk using microsurgery. Advantages over the pedicled TRAM include: improved blood provide (and thence less opportunity of healing problems as well as fatty necrosis), as well as less musculus sacrifice (so the abdominal recovery is a fiddling easier, potentially to a greater extent than forcefulness is maintained long-term, as well as the opportunity of bulging as well as hernia formation is lower).

Since the tissue is disconnected as well as transplanted to the chest, at that topographic point is likewise no tunneling nether the peel equally at that topographic point is alongside the pedicled physical care for as well as no subsequent upper abdominal bulge or as well as so the ribcage expanse (which is typically seen alongside tunneling).

3) The Muscle-Sparing Free TRAM flap: this functioning is associated alongside all the benefits of the gratuitous TRAM but has significantly fewer abdominal complications as well as side-effects (pain, bulging, hernia, forcefulness loss) because the vast bulk of the abdominal musculus is spared as well as left behind. The sum of musculus taken is typically real pocket-sized (postage-stamp size). We volition opt for this version of the TRAM entirely inwards the rare lawsuit that the patient's anatomy does non let for a DIEP or SIEA flap.

4) The DIEP flap: This is the most advanced flat of pectus reconstruction surgery available today. Like the muscle-sparing gratuitous TRAM, the DIEP uses the patient's ain abdominal peel as well as fatty to reconstruct a natural, soft pectus afterward mastectomy. Unlike the TRAM however, all the abdominal musculus is preserved. Only abdominal peel as well as fatty are removed similar to a "tummy tuck". Patients thence sense less hurting afterward surgery, savour a faster recovery as well as keep their abdominal forcefulness long-term. Since the abdominal muscles are saved, the opportunity of complications similar abdominal bulging as well as hernia are likewise significantly lower. Please view our gallery to persuasion DIEP flap earlier as well as afterward photos.

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Dr Chrysopoulo is a board certified plastic surgeon specializing inwards the latest pectus reconstruction techniques including DIEP flap surgery. He as well as his partners perform over 500 DIEP flap procedures per twelvemonth as well as are In-Network for most the U.S. insurance plans. Learn to a greater extent than near your breast reconstruction options as well as connect alongside other pectus reconstruction patients here. You tin likewise follow Dr C on Twitter!

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