Recycling stacked TRAM flaps for contralateral breast reconstruction

The transverse rectus abdominis musculocutaneous (TRAM) flap is a reliable tool in breast reconstruction. However, the necessary transverse excision of abdominal tissue involves the use or sacrifice of both the ipsilateral and contralateral flaps at the time of reconstruction, thereby limiting future options for reconstruction of the opposite breast in the event of a second primary cancer. As illustrated by this patient report, stacked TRAM flaps can be unstacked should future contralateral breast reconstruction become necessary.