pedicle tram flap complications

[otisman]

Inquiring if there are other cases similar to mine in which any resolution has been achieved, i.e. if there is any hope.

Underwent pedicle tram flap 12/2001 for right breast reconstruction utilizing left rectus.  Immediately felt tugging, pulling at site of dissection.  Lived for a year that way, saw many PS's, tests, etc.  General consensus was the mesh inserted was too short.  Surgery 1/03 to extend mesh which resolved that problem but afterwards developed bulge in RIGHT abdominal area.  To this point abdomen was flat and smooth and even.  Also following this surgery, left rectus muscle must have been "loosened" or the dynamics of the initial surgery undone as I now felt like a boa constrictor was unleashed and wrapped around my chest.  It was a totally unnatural, unbearable condition.  The muscle never atrophied, was still quite viable, would constrict and contract when innervated.  It was simply hell.

In May 2003 another MAJOR surgery to remove the remaining left rectus.  Following that surgery began the problems I suffer with now.  RIGHT abdominal area bulge hinders all movement and mobility and is debilitating.  Right rectus feels like a 2X4 implanted under my chest wall with splintered, rough edges.  Have been checked by PS, general surgeon, neurosurgeon, etc.  No answer & no one wants to look or touch me anyway.  My life is destroyed, it affects every second and every aspect of my life.

If I manually support this area I have enough relief for normal function.  Have been checked for hernia and informed none.  No surgical options & am very reluctant even if there wer

[CCF-RN,MSN-rf]

Dear otisman:  Although most TRAM flaps have good functional and cosmetic results, there is always a possibility that there could be complications, which you have clearly experienced.  Without examination, we cannot speculate as to what could possibly be done at this point to improve the situation.  One suggestion is to locate an expert plastic surgeon who may have some expertise in complicated cases.  These may be affiliated with a major medical center.

[otisman]

Have tried - went to Sloan Kettering - saw the head of the PS dept

had absolutely nothing to offer - was actually quite abrupt and rude

If he spent 5 minutes with me - that is generous

Have been to PS in Manhattan - private practice -



That is where my problem lies.  Do you know of anyone you could recommend???   Everywhere I turn, no one wants to touch me - I'm too much of a liability and no one wants to assume someone else's problems.

[elins]

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[gakki]

otisman

   my friend had a bilat. mastectomy and tramflap reconstruction

its been nearly 2 years and the complications just keep going.

she was in the hopital nearly 3 months after the mast. and reconstruction, developed staff and necrosis on abd. and breast areas. Had open wound for  a year or more.  now its back has

3 hernias , swelling in abd. bulging areas and the list goes on.

she can't work ,is in constant pain, vomiting daily,  Her wound care dr. thinks removing mesh and starting over the only answer

is recommending a dr. we hope that he will have answer. my friend in only 41 years old. you are not alone keep looking for help ....

we are

[J48]

My wife had a pedicled TRAM flap reconstruction and has had nothing but problems ever since. Her abdomin was so severly weakened that she cannot lift more than six pounds and has had to wear a support belt just to get trough a day on her feet. What really upsets me is the fact that not another PS would give her the time of day concerning this problem. They all acted like it was a huge mystery to them! Now she is going to lose her job because of this condition and we are looking for someone to help us prove that this is a real disability issue