When coverage for a defect cannot be achieved through skin grafting,plastic surgeons rely on other techniques to replace tissue.After mastectomy,reconstruction with a transverse rectus abdominis myocutaneous (TRAM)flap is one of several options for nonsynthetic prosthetic reconstruction.Another descriptive term for the TRAM flap is the:

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The transverse rectus abdominis myocutaneous (TRAM)flap for postmastectomy breast reconstruction is the most common pedicle-based flap used for breast reconstruction.The rectus muscle is the broad,wide abdominal muscle that extends from under the ribs to the pubis,and either one or both sides of the muscle may be used for reconstruction.The blood supply (superior epigastric artery and vein)is carried within the muscle pedicle.The muscle along with its pedicle is severed at its most distal origins and pulled through a subcutaneous tunnel to the chest to form a breast.Although this procedure has the added benefit of an abdominoplasty,if there is inadequate abdominal tissue the patient may require a small mammary prosthesis.

When Coverage for a Defect Cannot Be Achieved Through Skin