Reconstruction with tissue from the abdomen (TRAM/DIEP)

 

The myocutaneous flap of the rectus abdominis (TRAM) provides the possibility of reconstruction using autologous tissue, meaning full breast restoration with tissue from the patient herself without needing the additional placement of a silicone implant. The part of the abdomen located beneath the umbilicus is transferred to the chest and is used to create a breast that is symmetrical with the healthy one. It is applied to women who have excess skin or slack abdomen and have not undergone previous abdomen surgeries. The ability to use a large portion of fat and skin from the abdomen offers the advantage of creating a large breast.

This method has evolved significantly over the last years and with the advances in microsurgery we have been able to take this part of the abdomen without removing the rectus abdominis muscle. Thus, we have the advantage of no longer causing any functional problems in the abdominal wall due to the loss of part of the muscle.

This abdomen tissue (DIEP) contains only skin and fat and is practically able to create a similar breast, symmetrical with the contralateral one. The results can be excellent, and the fact that a silicone implant is not used is very important; consequently, the new breast shows the same progress as the other healthy breast, regarding the normal ptosis, the increase or loss of volume. Among the disadvantages of the operation, it is worth mentioning that it is rather long, although this is something that the patient does not realize. At the end of the surgery, the patient “enjoys” the correction of her slack abdomen. Corrective operation to the contralateral breast is rarely required.  

The evolution of plastic surgery techniques has now made it possible to reconstruct the breast using only tissue from the same organism (autologous tissue), in order to achieve a result as normal as possible, combined, of course, with patient safety. All modern breast reconstruction techniques applied throughout the world and mentioned above are also applied in Greece with great success. 

DIEP dd1 

DIEP dd2

DIEP dd3