TRAM reconstruction

SDM1984 · July 2004

Hi, my name is Sharon and this is my first time visiting the website. In the summer of 1997, at the age of 30yrs, I was diagnosed with Invasive Ductal Carcinoma in my right breast. I had a mastectomy followed by 6 treatments of chemotherapy. I'm writing because I'm thinking of having reconstruction, specifically the TRAM. I would like to hear from women who have had this type of reconstruction. My surgeon tells me this would be a very good choice, but I want to hear from women who have actually had it done. I hope to get some feedback. Thanks.

BBK · July 2004

I was diagnosed in November 2002, and had my mastectomy on January 10, 2003. At the same time, I had TRAM flap reconstruction surgery done. The whole surgery took 8 hours, and I spent 4 days in the hospital. I came home with 3 drains in, and they were in for about 3 weeks (they were taken out at different times, so some were in less than 3 weeks). I had some necrosis of the tissue, so it took 3 months for the wound to finally close up. I'm now a little over a year out (after recovery from surgery, starting in March 2003 and lasting until the end of May 2003 -- I had 4 rounds of AC Chemotherapy; no radiation). I have NO feeling in the new breast, and some hard areas that haven't softened, and at this point may not soften. I can live with it, though. I have no feeling in the center part of my body, where they tunneled the flap up from my belly. I may regain feeling, but then again, I may not. I still have some twinges of pain at all surgery sites (especially in belly area, and in my chest area, probably from the tunneling, too). I have NOT had a nipple tatooed on, and don't plan to. The scars are fading, but still noticeable. I'm pleased with the size, and that it is close to the breast I still have. It's hard to tell under any of my clothes, and looks and feels natural to people hugging me or whatever. My husband is pleased with the outcome. I have a bit of a cave-in on one side, but I can deal with that. All in all, I was very happy with the surgery and the outcome of the surgery. I had an excellent (!) plastic surgeon, and an excellent (!!) breast surgeon. There's a part of me that wishes I'd just had both sides done at the same time, and had TRAM flap on both sides. But, at the time, it was enough to deal with losing one breast. Now, of course, they're watching something on the other side, and once you've had Tram Flap for one breast, you can't have it done again to repair the other breast. So, if I ever have to go through this again, I'll have to explore other options for reconstruction. I'm hoping I don't have to worry about that any time soon.

I'm sure you'll hear from lots of ladies, and gets lots of advice. I did LOTS of research on the internet, and was glad I had the reconstruction at the same time as my mastectomy -- saved time, and probably big bucks for my insurance company (one surgery instead of two and so forth). IT meant a 6+ week recovery, and I walked like an old lady for a couple of weeks. But, a year later, I'm back to doing everything I did before. I'm finally feeling almost "normal" again.

Best to you! It's a tough decision. But, I felt it was the right one (!) for me!

SusanAnne · July 2004

Hi Sharon. I am 10 wks out from my TRAM flap for one side, also a delayed reconstruction. My mastectomy was in March of '03 and they wouldn't consider reconstruction at that time because they knew I was at least stage 3A, possibly more. They wanted to find out what they were dealing with first (turned out to be 3A). Anyway, my surgery lasted 8 hrs. I thought I was prepared for the pain that followed, I was not. There was much more pain in the midsection than I anticipated. I was pretty much miserable for at least 2-3 weeks. I have since been trying to stay active, because if you sit for any length of time, you stiffen up. I walk 2-2 1/2 miles a day, take a yoga class and have been going to physical therapy 3x/week for the last 2 weeks. I had a large area of hardness near my underarm (where the flap is under my radiated skin) which prevented me from having the range of motion I should have in my shoulder. I insisted on the therapy since I wanted to get back to being myself ASAP. I do plan on having a nipple constructed and some adjustments done. Like BBK I have an area that somewhat shrunk in and another that is fuller than it needs to be. My surgeon assures me that there are procedures to correct these minor imperfections. With clothes/bathing suit on, no one would ever know.
So, I just want to let you know, it is very painful. The first few weeks I was sorry I had done it. Now I am glad, although I'm not back to normal yet. Abdominals take a long time to strengthen up again and the pulling sensation from the "tummy tuck" takes a lot of work to stretch out. Ask your surgeon if you can speak to any of his patients who have gone thru it.
Good luck and let us know what you decide. If you'd like me to answer any questions for you, feel free to email me.
Take care,
Susan

joan57 · July 2004

Hi Sharon. I am 47 and had a bi-lateral mastectomy in March 03. Only had cancer in my left breast but made the decision to go bilateral. My plastic surgeon told me that because of radiation, my only option is a flap procedure. I am scheduled for the bi-laterial tram flap reconstruction on Sept. 23. I think it is the best choice for me to move on. I notice some people mention loss of sensation. I actually am not surprised about that because I still have areas with no sensation around my mastectomy. I expect this to be similar because of all the cutting of nerves and the like. Let me know what you decide. Maybe we can be 'recovery buddies'. Please feel free to e-mail me directly if you wish. Joan

seeknpeace · July 2004

HiThere,

I had a bilateral mastectomy with tram flap immediatly afterward on 2-4-04. It is a hard surgery, and I opted to have the non cancerous breast removed also as I had already had a lumpectomy on that side, and my type of cancer was very aggressive. While it was dcis, it measured 2.5 cm and had a lot of necrosis in it, as it was not getting the blood supply to sustain it's growth, so it was ready to bust out.

The surgery does hurt, and a bilateral maybe something you want to discuss with your doc as well. You reduce your risk of getting cancer in the cancer free side, you have much better symetry, and barring anything going wrong, you never have to have it redone. With implants, they have a life from 10-15 years, so you will have to have them redone most probably.

I, too, walked like a little old lady. I have had two surgeries since. The first to remove some tissue from the right side that was not softening up, and yesterday to have my lower abdomenal scar revised, and to have nipples put on my breast. Soon as they heal, I will have the tattoo.

I am so glad that I went with the tram, and so glad that I did it bilaterally. They look really good.

If you do go the tram route, be sure to take gowns that open in the front. That will allow the nurses to attend to your incision sites and the drains. If you wear pjs with bottoms, the lower incision will be irritated. So, you don't want to wear anything that you don't have to on that scar. I had four drains, one on each breast and two in my pubic area.

Also, a couple of small pillows, like an infant baby bed size, helps too for you to support your arms with while in the hospital and when you go home. I was much better after 6-8 weeks. The recovery is longer.

Good luck to you honey.

Jan

franalynn · July 2004

Hi Sharon. This is my first visit to this site too. I was diagnosed with the same CA as you, stage 2b of the rt breast in Dec 14,1998, at the age of 39. I went through 4 rounds of chemo (the 1st one 4 days before Christmas), then mastectomy (March of '99) then 4 more rounds of chemo followed by 6 weeks of radiation--finished treament in August of '99 (my tumor was large--6 cm and thankfully, I had 19 negative nodes removed). Next month, I will be 5 years cancer free. In April of '02, I had the TRAM done and I'm glad I did. Yes, the surgery is extensive but I didn't find it to be any more painful than the 3 C-sections I have had. The hardest thing I found was having to be kept very warm while still in the hospital after the surgery--to keep the graft from failing. There were two heat lamps on me at all times for the first 3 days post-op and I felt like I was roasting (too bad they weren't sun lamps--I could've at least gotten a nice tan!) I was on convalescent leave from work for 6 weeks and mobility was a little tough--can't sleep completely flat for about a week and of course, can't drive. I was sore and a little stiff but I'd do it over again if I could. The benefits far out weigh the temporary discomfort and yes, like the other ladies stated, there is numbness in the surgical areas but it's easily forgotten. I still need some "fine tuning" of the reconstructed breast--just haven't had the chance. I feel whole again and no one can tell the difference with clothes on of course, and the tummy tuck is fabulous--especially after having 3 kids!!! The idea of never being able to do sit-ups again doesn't upset me either! I feel better now than I have in years. Just remember, whatever you decide, it's your decision and you have to do what feels right to you. The small pillows are a good idea and maybe one of those cooling things you wear around your neck to stay cool--I sure could've used that!

My prayers are with you and know that the discomfort is temporary and "this too shall pass".

Please feel free to email me if you have any other questions or just want to chat.

Take care,

Fran

TRAM reconstruction

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