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Breast Reconstruction with Flap Procedures

Your surgeon can help you decide whether to have reconstructive surgery. You will be advised to wait if now is not the best time for you.

A flap procecure uses your own tissue to form the shape of a breast. There are two kinds of flap procedures: the TRAM flap and the LD flap.

Cutaway view

TRAM Flap

The TRAM (transverse rectus abdominis myocutaneous) flap uses abdominal muscle, fat, and skin. The new breast feels soft to the touch. A flap of skin and fat is removed from the lower part of the abdomen. Then the flap is tunneled under the skin from the abdomen to the mastectomy site. There the flap is formed into the shape of a breast.

Cutaway view

LD Flap

The LD (latissimus dorsi) flap uses back muscle, fat, and skin. The new breast feels soft to the touch. The flap of skin and fat is removed from the side of the body, over the ribs. The latissimus dorsi muscle is left attached to the flap. Then the flap is tunneled under the skin to the mastectomy site. There it is formed into the shape of a breast.

Note to Smokers

Refrain from smoking 3–4 weeks before and 1–2 weeks after your procedure. Smoking can interfere with the healing process.

Risks of Flap Reconstruction

  • Infection

  • Muscle weakness

  • Scar tissue

  • Increased complications in smokers

Publication Source: Burns JL, Blackwell SJ, Sabiston Textbook of Surgery, 18th ed., Chapter 73 - Plastic Surgery, 2008, pp 2144-2146
Online Medical Reviewer: Trahan, Katherine MD
Date Last Reviewed: 1/15/2007
Date Last Modified: 8/1/2005