The Pedicled TRAM Flap for Breast Reconstruction: Animation of the Procedure

The TRAM (Transverse Rectus Abdominis Muscle) flap procedure requires taking the entire Rectus Muscle (1 set of the 6-pack abdominal muscles) to reconstruct the breast.  It can be done as a Pedicle Flap (as shown here, the blood vessel and muscle is still attached), or as a free TRAM flap requiring microsurgery to reconnect the tissue to blood vessels in the chest area.    The DIEP flap procedure has evolved from the free TRAM flap where the muscle is preserved and the skin and fat is removed from the abdomen with only the blood vessels.