Muscle Sparing Tram Flap

Muscle sparing tram flap I am having breast reconstruction, and the surgeon suggested a muscle sparing tram flap rather than DIEP saying that the ms tram flap is a safer and more reliable option saying that the abdominal weakness would be the same which ever op I had. I would like to know about anyone who has undergone this procedure recently. What do you think? What should I expect after surgery, recovery time and any othe. Every thing I have read tells me the DIEP is the gold standard of reconstruction but my surgeon does not agree - I am taking his advice and agreed to have the ms tram flap but just wanted to make sure I have made the right decision. Many thanks.

Hi, yes I was told that the DIEP is the Gold Standard and if you get anything else you are being ‘shortchanged’!   I do think it depends on your team, your body and your circumstances.  When I had my discussion with my PS he said a DIEP but he also felt that he might have to take some muscle from my tummy dependant on the state of my blood vessels when he opened me up.  If you google it says either DIEP and if you have muscle taken then its not a DIEP its a Tram Flap - I too was confused.  On the letter he sent to my GP it said DIEP/Tram Flap.   My PS  told me  he got better results if he used a bit of muscle - basically he said that the new breast was less likely to fail if he used mucsle - his results were 97% success.  I do think you have to have trust and faith in your team and go with what they advise, they do know best.   Anyhow I had my DIEP/Tram Flap - they did use a small bit of muscle from my tummy but he put mesh in to strengthen my tummy muscles (I think without the Mesh you can have weakness) .  I had my Op in 2011 and I have the most fantastic new breast and a lovely flat tummy.  I go to the Gym twice a week, can exercise as normal and have had no problems at all.  If you ring the ‘someone like me’ line BCC can put you in touch with someone who has had this procedure and you can actually chat to them on the phone.   good luck x  

Hi Crazybirdy and welcome to the BCC forums

As Saffronseed has said, our helpliners can put you in touch with someone who has had reconstruction, you can read more about this service here:

breastcancercare.org.uk/breast-cancer-services/talk-someone

Here’s a link to the BCC reconstruction information which you may also find helpful:

breastcancercare.org.uk/breast-cancer-information/treating-breast-cancer/surgery/reconstruction

Take care
Lucy BCC

 

Hi crazybird,

 

I had a MS tram flap four months ago. Had always discussed a DIEP with the surgeon but they were very clear from the start that if  once underway they felt it would be better to swap to MS tram that they would. I have just a small postage stamp of muscle missing and I don’t think in the scheme of things this has affected my recovery or a very, very natural and pretty close to the other result (new boob). I dont think it’s the plumbing that makes everyone cal DIEP the gold standard rather the result - soft and hopefully maitnenance free. Unusually for me I decided I was way out of my depth re making decisions on the right route with this one, felt OK with the surgical team so trusted them!!

 

. The decision was made to swap to MST as due to my last baby being a C-section and some previous abdo surgery for a fibroid I had a little bit of damage to one or two of the vessels and surrounding area…

 

Anyway I was out of hospital within 4 days… took it very easy for 3-4 weeks at home and then after the 6 week check got back to everything I usually do. I have 4 kids so am pretty busy generally so got back to that OK. Getting usual fitness levels back up has been a bit of a slog  but doable… The scars take a bit of getting used to but I’m assured they fade.

 

If I can help with anything else please PM …