In a TRAM flap procedure, skin, fat, and muscle from your lower abdomen are used to reconstruct your breasts. There are two types of TRAM flaps — a pedicled TRAM flap and a free TRAM flap. The rectus abdominus muscle (also known as your “ab muscle”) is included in this type of flap surgery.
In a pedicled TRAM flap, the muscle and tissue remain attached to their blood supply in your abdomen and are moved to the chest wall to recreate a breast.
In a free TRAM flap, the tissues with its artery and veins are disconnected from their origin blood supply, relocated to the chest wall to recreate a breast mound, and reconnected to recipient arteries and veins in the chest.
This is a more complex surgery and involves microsurgery techniques. Microsurgery is surgery that uses specialized instruments, including an operating microscope to connect intricate structures like blood vessels and nerves. Recovery is typically longer.