Tram Flap and Complications

MsTori

TRAM FLAP RECONSTRUCTION AND ABDOMINAL BULGE/PAIN

I had the Bilateral Pedicle Tram Flap in 2012. Less than 3 months later, my abdomen began to grow larger and, very painful. After chemotherapy finished, I began to investigate...being an RN, it’s in my nature to look at online journals. I knew something was wrong, but what? I contacted many surgeons throughout the country. It wasn’t until I found two surgeone on LI, NY in March 2013, that I found out I had developed 3 abdominal hernias related to the Tram Flap. In May 2013, I was repaired successfully after meeting with these two very skilled surgeons who developed a technique to repair Tram Flap hernias and bulges. I found out that the Tram Flap comes with a >40% risk of developing hernias. I started a FB group in early 2016 related to Tram Flaps and yes, even some Dieps Flaps that have developed hernias and bulges. TRAM/DIEP- Complications And Hope. I’m under Tori Gaskins as well. My FB group is growing daily beyond what I ever anticipate. 

If you are out there and have had the Tram...in any form- Bilateral Pedicle Tram Flap, Unilateral Tram Flap, Free Tram Flap, or even a Diep Flap and, are experiencing abdominal complications, please know that your not alone. You have a sisterhood of women that are experiencing the same issues. Many have already been repaired successfully by these surgeons. I am now almost 5 years out from my own repair and it’s holding very well. My surgeons have now published their repair in the Atlas Of Abdominal Wall Reconstructio, Vol. 2, by invitation of the head of the Cleveland Clinic. They have spoken to surgeons from across the country on their repair at a conference in 2016. There is HOPE. Your PS is not the person to turn to in the case of repair of abdominal wall complication. They perform these surgeries but, unfortunately are ill equipped to address our abdominal issues afterward. 

If you are considering the Tram Flap, please understand the risks. Even in very skilled hands, there are risks. Surgeons tend to downplay these risks. And they don’t understand what it is to live physcally and mentally after having the Tram Flap. I won’t deter women, as I respect everyone women’s choice but, I want you to know what this surgery entails and, what it’s like to live in a body after this surgery. Some surgeons will say this is your only option for reconstruction. And we want to feel whole again....to replace what was taken. It wasn’t until after my repair that I found out that what my original PS told me- expander to implants or Tram Flap were my only options...was in fact incorrect. I had many options.

Feel free to contact me and ask any question. I’ve been actively trying to reach out to women since my own repair in 2013 and help educate those looking at this surgery as a means to reconstruct. 

Birdface

Tram flap complication

I had single mastectomy , tram flap reconstruction, chemo eleven years ago. First few years the odd probleme stitch would come through my abdomen, repaired. It happened three times. Then four years of stomach pain, enormous bloat, ileus. That's when your intestines shut down. Turned out I had an umbilical hernia. Had it repaired a year ago, all fixed, happy happy. A couple of months ago I coughed and felt like everything had come apart. Surgeon said massive surgery to repair stretched and torn scar tissue. Second opinion surgeon said no problem with the mesh, all just fine. I have to wear spanx and or an abdominal binder all the time. I'm a wreck, feeling like this is not a life. Anyone experience this sort of thing? I'm uncomfortable all the time. 

CRgirl

Tram Flap and Complications

Birdface, I have also been dealing with the same issues that you have. I also have to wear a binder all day, there is NO way I could go without one. My doctor also said massive surgery would be involved to fix it and it could cause the tram flap breast on my right side to go bad. I wcant even believe they recommend this surgery option to breast cancer patients!!!! I wouldn't wish this to anyone. My hernias (I have 2) limit my activities. I am frustrated and understand what you are feeling.  

QueenBee123

MsTori, I'm new here so

MsTori, I'm new here so please be gentle.  LOL.  I couldn't sleep for the second night in a row and my self-research sent me to this site.  I came across your Post here that resonated with me.  I also had a BiLat TRAM *Flop*, as I call it now.  I was diagnosed in 2011 and was diagnosed with IDC and had a TRAM Flap with immediate reconstruction.  My story is long and so involved, but I'll cut to the chase.

Here it is ten years later, and the suffering gets worse with the growing years.  I have no abdominal muscles because they now form my chest.  Whenever I walk, I can feel my abdominal muscles pulling, trying to work, but they're stretched and I find myself not being able to go on long joyful walks ever since I had this surgery.  I, too, ended up in NY to see if I could have this reversed, but not able to.  I'll bet the two surgeons I spoke with were the same two you discuss here.  I was told they could help me, but I'd have to stay in NY for about a month and finances couldn't afford it so here I am with a massive TRAM bulge that's negatively affecting my quality of life.

In my early search for the best possible outcome pre-surgery, I wanted a DIEP Flap, which is muscle sparing, but the PS I went to said I was too heavy and that I could only have a TRAM Flap.  I later found out he lied because I met a couple of women who had the DIEP Flap and one was a heck of a lot heavier than me and she looked great.  I also found out he only did TRAM Flaps so instead of recommending me to a PS who could do the DIEP Flap on me, he lied to me and now I feel frustrated and alone.

I don't know if you'll be able to see my Post here or can reply, but I did get this off my chest, pardon the pun... 

kartist

Hello not happy to see other women with the Tram Flap failure and continued problems!! the surgery is barbaric i am told after the fact and should be outlawed! as per a surgeon I saw in Southern California for Gal bladder removal. He was the first surgeon to wal into my hospital room and know exactly what happened to me. Tram Flap reconstruction, Fluid, another surgery to insert tubes, pulmonary embolism, cust off blood supply to Tram breast, removal of Tram breast ( 2 mastectomies in a month ), Hernia from Tram site, Ping Ponged to 3 surgeons, 9 months later hernia to 9 months pregnant size, back to first 2 surgeons-plastic and breast--repair with mesh 30.5 x30.5 doubled over and stitched under pubis and up above belly button. stitches are at least 10 gauge size..The repair is holding guts intact but painful due to contraction(hardening) causes pulling and extreme pain and nausea back and hip issues continuously at drs and pain management. When i researched this surgery it was less than 4% problems which is now 40% its not problems of the mesh brand its problems with the surgery and lack of good repair if failure. My doctor did not discuss risks and was his first TRAM surgery and it was a failure . He stated thta he probably compromised the surgery by the second surgery to insert tubes he did some CLEAN UP whatever that means but still there are failures without clean up.

I had my TRAm surgery in 2010 and my failure began within a month of having to have second surgery to reinsert tubes because of fluid intake at site. Immedialty began bulge which was small. I saw plastic surgeon who sent me to Breast Surgeon(both doing initial surgery together) breast surgeon says go back to plastic surgeon I said why? he sends me to top plastic surgeon in Las Vegas where I resided at the time. Surgeon stated he would fix..waited..surgeon changed mind...was sent to another plastic surgeon..says can f ix but difficult as the bulge was now size of 9 months pregnant and living in a uncomfortable hot binder and intense pain, bloating, and pulling of all muscles of abdomen, hips, back, illengual nerves etc. New surgeon wanted records form original plastic surgeon. arrived at plastic surgeon office and he had a fit he had no idea other surgeon sent me on a wild goose chase.. 2 surgeons did repair immediately!

I have had continuous pain management care and physical therapy for said problems with Tram flap failure Hernia repair...and seen many surgeons in Southern California and pain management doctors state there is NO FIX for the FIX only removal of said contracted mesh that has hardened and causing crucial pain in surrounding areas and deformity and scar tissue tears. I am now off all pain medication and deal with all this through natural medicines and have other comples health issues as well from the Chemotherapy and lack of stomach strength such as Migraine Vestibular disorder , vertigo--all types, chronic pain in hips, back, shoulders, neck, legs, groin, stomach, legs and arms. This is the only regret I have in my life a choice to have my own body as a breast it FAILED and the literature was incorrect and my surgeon did not discuss the risks as I had researched myself being a researcher myself in academics and in my professions of Public Service which is now obsolete because of my choice to have said surgery. I do not blame the surgeon hower i do blame surgeons for the lack of communicating and waiting for hernia to grow to be so large and for Plastic surgeon to say when all said in done I ask what did you learn from me as a patient. He said everyone is different! hmm but it could have been different from beginning if I would have asked him more questions, he would have explained this would be his first TRAm surgery and RISKS involved which were low but now rather HIGH. Less than 4 % now known to be more than 40% hmm crazy significant difference. I have not worked since JULY 26, 2010 had initial surgery August 3, 2010 and Last surgery of repair Sept 2011 I have not worked since and have a multitude of problems form said surgery and chemotherapy. My decision was wrong, Today, my only regret and wish for a redo would be to have both breast removed and tattoo a top on so i can can go with no shirt like when i was a kid/tomboy lol For those having to go through this I pray for you and feel for you. I had an attorney contact me and said he wants specific medical records to take it to the top and no hush money..ive been fighting for disability for 10 years. I was awarded a 1 time limp some of 12K and said i could go back to work,,,I wish im still not able to work I submitted a new claim and it has now been appealed and appealed it is in Federal Court just sitting there because courts are closed due to COVID...nightmare I filed a case as it went Federal and am now over 1 year mark and they rAre in the DECISION stage but now they received all records including psych record now they want me to go to their psychiatrist 3.4.23 shame on them I have all the same problems as awarded in 2014 and worse needing more surgeries and my abdomen is a mess..I have other issues from the chemo never again no more chemo no surgeries no meds im done and ready for what comes my way..11 years of hell Im going to live the best I know how with little and Im happy body is failing but not my mind heart and soul..

triplegirl

Thank you for sharing your experience...so very sad for the heartache and pain. Your truthful story needs to be heard.

Wishing you strength and resilience .

kelliemak

I had free tramflap after double mastectomy in 2012. I healed well but now, 11 years later I’m experiencing swelling and pain under my scar. Feels like I’m carrying around rocks, just heavy feeling, tender to push on. Went yesterday to the dr, gave me Keflex saying I might have a bladder infection but nothing came back positive for that. Achey legs too. Any advice?

terivessella

When I do a sit up (6 years after the tram flap reconstruction), I feel like there is an alien protruding from the right side of my abdomen. I'm experiencing nerve pain below the breast area. It feels like all of my organs have been forced into the area above the tram flap scar. It's like the scar tissue has created this barrier. I don't know what to do!