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tram flap problems
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tram flap problems

Has anyone experienced a large firm abdomen following a tram flap masectomy.When i walk it gets worse and after meals as well.  
This started one yr after my surgery. I thought you were suppose to have a tummy tuck bonus.  My stomach is far from flat.
Also ,when they use your fat from your abdomen to replace the breast tissue, is it normal to gain weight in your breasts?  thanks for any advise and answeres  teddy1
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Avatar_n_tn
Dear teddy1:  Outcomes from surgery depend on several things; the type of surgery, the technique of the surgeon and the individual response to the surgery.  Some people are prone to developing more scar tissue than others, for example.  A tram flap uses the muscle from the abdomen to make the breast shape in addition to fat and size of the reconstructed breast can change with weight loss or gain.  If you have concerns about the abdominal site, you might benefit from a discussion with your plastic surgeon.
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Avatar_f_tn
My tram was over 2 years ago, and my stomach was flat for about 6 months.  Yep, I've gained 30 pounds and so did both breasts.  Plastic surgeon sain, "yeah, that's the trade off with tamoxifen."  Good thing I didn't do an implant.  He also said, "where?" when I pointed out the uneven bulge.  Navel is off center by an inch and he told me he'd rather fix it after I lose the weight.  Bulge gets worse when I've been on my feet too long.  Now I'm sweating on Aromasin, and the weight's not coming off.  I just avoid mirrors.
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Avatar_n_tn
thanks for the message. i feel better to know im not alone . i thought something was wrong with me. not that i want u to have any troubles . i just didnt kow what was going on .  teddy1
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Avatar_f_tn
You asked if it was normal--that I don't know.  I do know others who didn't gain weight, but they do bulge.  I would have liked to know that it was going to happen.  I was told it is because we now lack the extra muscle that used to hold it in. My plastic surgeon did an excellent job on my tram--I look pretty much the same because they were able to save the nipple.  I didn't even need a revision on the other.  He said my navel would move back and the bulge would go down but they didn't.  My husband says it's not a big deal, but it bugs me.  The surgeon was also bugged, but not in a hurry to fix it.  An do I really want to have surgery again...?
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Avatar_n_tn
i thank you for your comments. if any one else had some past experience who had a tram flap . please tell me how yours was.  and if you had tummy problems and how u may have corrected them. i feel as though i am living with this problem and dont know what to do. teddy 1
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Avatar_n_tn
Isn't a DIEP FLAP better than the TRAM?
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Avatar_n_tn
Hi!  I don't know how much help I can give anyone as I am post-op 4 1/2 weeks now from a right breast mastectomy with tram-flap done on the same day.  Prior to this surgery I had a routine mammogram in Feb. and follow up suggested very suspecious calcifications.  On May 26th I had a stereotatic biopsy with a mamogram (mammogram) just prior to the biopsy that showed 2 more suspecious sites.  The 2 other areas couldn't be biopsied because they were too close to the nipple.  I have been told I have very dense breasts.  So, the path report of one site that was biopsied showed I had DCIS.  I had lumpectomy x3 in June which showed the other two sites also contained DCIS, comedio necrosis (which I have been told means the DCIS is aggresive (aggressive)), and LCIS. I had another re-excison in July on 2 of the 3 sites that did not get clear margins. I was given the option of another re-excision or a mastectomy.  I questioned the doctor about his expert advice and he said he didn't think he would get clear margins if he went back in again.  So, I decided on the mastectomy. I had developed a frozen shoulder which was believed started due to the lenght of time I was positioned for the sterotatic biopsy.  I had to have arthoscopic surgery on my right shoulder before I could get the mastectomy as I could no lift my arm above my head. I viewed all my options regarding reconstrution and felt Tram Flap was the way I wanted to go.  I spoke to several women who had it and all were satified. I even met a patient of my plastic surgeon who showed me her results and she looked great.  Well, now to my surgery.  I needed 3 units of blood after my surgery because my blood count droped from 36 to 16 then I started spiking fevers of 102.  I left the hospital feeling pretty good. Was in for 5 days.  My roommate had the same plastic surgeon and seems happy with her results.  I have two open wounds on my abdomen (the belly button and the left side of the abdominal incision) and a gapping opening on my newly created breast that became notice able after the necrotic scar tissue came off.  I also started to spike fevers after I was home for 2 days. I have since been on six different antibiotics, had 3 wound cultures, and seen an infectious disease doctor.  I am happy to say that today I will be taking the last of my antibiotics.  I don't have any fevers and the draniage from the abdominal wounds had decreased tremendously.  The plastic surgeon told me the abdominal wounds will heal themselves and form scar tissue. He said since a belly button is scar tissue that it won't be a problem.  He said I may want to do something about the abdominal scar later as it may heal with an indentation.  To tell you the truth I don't really care about an indentation.  What is really bothering me is the newly created breast.  The muscle from my abdomen the was unsed is protruding on the inner aspect of the breast and I can't put a bra on due to this. The doctor recommended I get a sports bra.  My right breast also feels swollen and pushes against my right arm.  Is this normal????  I will see the plastic surgeon on the 26th.  Can anyone help me with questions to ask him.  I feel like I don't have a breast just an ulgy open mass on my chest.  I believe that a resident did my surgery under his supervision and that is why my breast is so messed up.  Do I dare ask him if this is the case?  My advise to anyone going for this surgery is that they tell their plastic surgeon that they want him/her to do it and a resident only to observe.  I would like to learn about anyone else's expierence with tram flap and how they handled their complications and the outcomes.  Am I just flipping out?  Will my right breast look normal if I just let it heal on it's own?  Anyone else get a frozen shoulder? I am going to physical therapy 3 time a week but don't feel it is getting any better and feel the abdominal muscle in my chest is helping to prevent me from lifing my arm up.  Anyone else dealing with this?  Is there a light at the end of the tunnel?  I also was told the pathology report from the tissue taken to reduce my left breast shows I have LCIS in my left breast.  The Oncologist first said he wouldn't reccommend Tamoxifin (tamoxifen) because risks didin't out weigh the benefits in women who had a mastectomy. He felt there was no need for it.  I mentioned I was sorry I didn't have a bilateral mastectomy.  When he asked why, I mentioned the LCIS in the left breast. I guess when he was going over my latest pathology report he misses seeing this as he was concentrating on my right breast. He told my husband and I to stop by his office after I made my 3 month follow up appointment.  He did a 180 degree turn on his advice on taking  tamoxifin (tamoxifen). He said after considering the LCIS in my left breast he would reccommend me taking Tamoxifin (tamoxifen).  He said I could wait until I am off all the antibiotics and am healed before I start taking it if I wanted.  Question?  From all the reseach I have done about LCIS--everywhere says they don't treat LCIS they just closly monitor you as a large majority of women with LCIS it never progresses further. So, are the risks of tamoxifin (tamoxifen) worth taking it when the risks of LCIS progressing into invasive cancer are so uncommon?  Well, now that I have bent everyone's ear for thoes of you who took the time to read all of this, I say thank you for letting me vent. If anyone has some words of advise or words of wisdom please pass them on to me.
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Avatar_f_tn
A related discussion, Hernia in the mylar net in my stomach was started.
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