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reverse tram
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Questions in the Cosmetic Surgery forum are answered by Dr. Howard Rosenberg and Dr. Wolfeld. Topics include bariatric surgery reconstruction, breast augmentation, chemical peels, cosmetic or reconstructive surgery, face lift, nose reconstruction, and tummy tucks.

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reverse tram

Hi,

Due to a bilat mastectomy in 04, I chose a tram flap and of course sacrificed my ab muscles.  It looks as if I may have recurrence and I have never been happy with the tram, always wanted the diep.  The tummy tuck idea was always a bonus but the ab sacrifice never was.  Mesh seems to give as time goes by and my bundled ab muscle is very large under my reconstruction as to be awful.  So, with no waist, a rounded tummy of sorts, that shelf for my "breasts" to lay on, I really feel like a freak.  I have never "loved" the reconstruction.

My question is this. Has there EVER been a reversal in the ab muscle, can it be returned and reattached?  Has there ever been a cadaver muscle used? I know this sounds awful.  I am certain that all blood supply is intact to my things they call breasts.  I weigh quite a bit less than pre cancer and the less I weigh the worse this gets.  And now with the possibility that I may lose these lovely jewels, to think that I gave up my ab muscles to keep only natural tissue in my body, only to now have to decide on an implant again, makes me sick.

Anything you can shed light on please?

Jan
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242582_tn?1193616720
The abdominal muscles originally supplying the vasculature to the TRAM flap are no longer required for this purpose.  They certainly can be reduced or removed, but reposition back in the abdominal wall is not an option because of retraction and loss of nerve supply.  Additional reinforcement of your abdominal wall may be possible, but not with cadaver muscle.
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460066_tn?1206453487
Thanks for answering me on this.  I do want that thing, that budle, out.  So, if I have to be operated on again, as it seems I will, they can just take that out and reinforce my area.  But, it is a double headed sword.  If they do too much, you always feel like you are wearing a bra.  All the time.  
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