A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction | Journal Article CME-Journal CME Article: A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction v1

Journal CME Article: A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction v1

Video Transcription

Preoperative surface markings are best performed with the patient in a standing position.  You need to address the opposite breast as the goal is to obtain a symmetrical reconstruction. The limits and shape of the breast mound are transferred from the contralateral breast  to the mastectomy site, accurately marking the width, the height, and the estimation of the projection.  If the breast is too large, then a breast reduction or mastopexy can be carried out at a later date.  The flap design on the lower abdomen starts with the upper transverse line approximately one centimeter above the umbilicus to capture the periumbilical perforators.  The lower transverse line of the flap should conform to the width of the base of the desired mound reconstruction.  The vertical line at the base of the flap may be drawn in a curve to lengthen the bait's width. Marking the costal margins is important to establish the limits of the upper flap and  the subcutaneous tunnel into the mastectomy site.

Video Summary

Preoperative surface markings should be done with the patient standing to ensure symmetry with the opposite breast. The shape and dimensions from the intact breast are transferred to the mastectomy site to plan the reconstruction. For larger breasts, reduction or mastopexy might be done later. The abdominal flap design begins with marking the upper transverse line just above the umbilicus to include crucial perforators, and the lower line matching the base width of the desired breast mound. A curved vertical line can widen the base, while costal margin markings define the upper flap limits and mastectomy site access.

Keywords

preoperative markings

breast reconstruction

abdominal flap design

symmetry

mastectomy site