Liposuction 2 Years After Tram-flap Reconstruction?

As stated before, it is very safe to undergo liposuction following a tram flap provided there is no evidence of hernia.  Moreover, please go see your surgeon to evaluate the bulge to make sure that it is not the muscle itself.

Yes, having undergone a TRAM flap would not be an impediment to abdominal liposuction. However, you should ascertain whether any area under your breasts is bulging because of the healing of the flap as opposed to fat pockets.

Lassie,
If possible and desired, your best option to seek the most informed answer to your question is to see your reconstructive surgeon. I regularly perform breast reconstruction (TRAM flaps and other reconstruction methods) and cosmetic procedures (liposuction included) in my practice. There may be a bulge in the upper abdomen from a portion of the TRAM flap itself depending on the exact technique utilized which can really only be answered by your surgeon or a review of the operative notes. If there is excess 'fat' that you noticed only recently as opposed to immediately after surgery, in this area, this may be able to be addressed with liposuction with no damage to the reconstruction. The TRAM flap tissues that are transferred to the chest to reconstruct the breast after mastectomy are often based on a blood vessel that runs in the rectus abdominus muscle that is tunneled under the skin of the upper abdomen and into the chest, and this may account for a bulge in this area. However, this is typically noticeable immediately after surgery and gets significantly better with time as the muscle shrinks. I hope this has helped you.
Dr. Sean Simon