Using Abdominal Tissue for Breast Reconstruction: Tram and Free Tram Procedures

Using tissue from the abdomen, specifically the transverse rectus abdominis muscle, a procedure called a TRAM flap was traditionally used for breast reconstruction. The skin and fat connected to the muscle were moved from the abdomen to the breast. With the advancement of microsurgery, a free TRAM procedure was developed where the blood vessels were disconnected and reconnected. This allowed for more flexibility in the procedure. The deep inferior epigastric artery and vein were typically cut off from their takeoff point from the iliacs for this process.