Flap-Based Breast Reconstruction Techniques
There are three common approaches for flap-based breast reconstruction.
The TRAM flap option, or transverse rectus abdominis myocutaneous, refers to the muscle located in the lower abdomen from which skin, fat and muscle can be used to reconstruct a new breast. This procedure uses excess skin and fat, in addition to the underlying abdominal wall muscle, which contains blood vessels that feed the overlying skin and fat. The tissue is tunneled under the skin up to the chest while keeping the blood supply intact.
DIEP flap breast reconstruction refers to the deep inferior epigastric perforators, or the skin and fat from the lower abdomen. This approach is similar to the TRAM flap option, but does not use abdominal muscle, minimizing abdominal weakness and the risk of hernia formation. Fat and skin from the belly button region are relocated to the chest wall and connected to blood vessels in the chest.
The LDMF, or latissimus dorsi myocutaneous flap, is another breast reconstruction procedure that uses your own skin, muscle, and fat. The latissimus dorsi muscle lies under the armpit and continues diagonally across the back. Because of its proximity to the chest, this is a popular muscle to use for breast reconstruction as it can remain attached to its original blood supply. This technique can be combined with implant-based reconstruction to add volume to the breast as needed.