[Planning the TRAM flap in reconstructive breast surgery after mastectomy. Transverse rectus abdominis muscle]

The guidelines for postmastectomy breast reconstruction are the contralateral healthy breast. We tend to provide symmetrical reconstruction without or with minimal modification of the contralateral breast. The technique we are using for preoperative planning allows immediate de-epithelialization and tailoring of the dermoadipose extensions of the flap at the beginning and not at the end of the operation. This reduced operative time and the need for secondary correction and contralateral mammaplasty.