Preoperative TRAM flap planning for postmastectomy breast reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery

Background:

• Existing transverse rectus abdominis musculocutaneous (TRAM) flap planning lacks adequate preoperative marking guidelines for diverse contralateral breast types.
• Reconstruction often aims to mirror the contralateral breast, necessitating precise preoperative planning for optimal aesthetic outcomes and patient body image.
• A need exists for a simple, reliable method for preoperative marking in TRAM flap breast reconstruction.

Purpose of the Study:

• To present a novel, simple, and reliable technique for preoperative marking in TRAM flap breast reconstruction.
• To provide adequate guidelines for preoperative marking adaptable to patients with varying contralateral breast morphology.
• To improve the efficiency and outcomes of TRAM flap breast reconstruction.

Main Methods:

• Development and implementation of a new preoperative marking technique for TRAM flap planning.
• The technique allows for immediate deepithelialization and tailoring of dermoadipose extensions at the outset of surgery.
• Focus on utilizing minimal contralateral random portion of the skin island to reduce complications.

Main Results:

• The described technique significantly reduces operative time.
• It decreases the need for secondary corrections and contralateral mammaplasty.
• The incidence of marginal flap necrosis and liponecrosis is reduced.

Conclusions:

• The proposed preoperative marking technique is simple, reliable, and applicable to most patients undergoing TRAM flap breast reconstruction.
• This method enhances surgical efficiency and improves aesthetic results by enabling precise flap tailoring.
• Reduced complication rates, including flap necrosis, are observed with this technique.