Did you know that one in eight women living in America today will be diagnosed with breast cancer in her lifetime and it’s a number that is on the rise? I’m Dr. Paul Vanek and I’m a board certified plastic surgeon.

October is breast cancer awareness month and in America, more and more women are being diagnosed with breast cancer. Back in the 1970s, the number was one in thirteen. By 1990, the number had risen to one in ten. And in 2011, it’s now more than one in eight. 120,000 women undergo mastectomies each year and of those, about a quarter of them undergo breast reconstruction. Breast reconstruction has changed over the years and right now, the most popular method of making a new breast is TRAM breast reconstruction. T-R-A-M stands for Transverse Rectus Myocutaneous flap but it’s obviously easier to just simply call it a TRAM.

Women who elect the TRAM reconstruction have the supple tummy tissue relocated to the area where the breast was, then the skin that is removed is closed down in a tummy tuck line. Now, what that means for you is that your breast tissue is removed as a mastectomy by a general surgeon and you can get a flat tummy and new breast volume so that your breasts match. Reconstruction is either immediate, or delayed; immediate meaning the day of the mastectomy, or delayed meaning any time after that. The low tissue of the tummy area is turned up on the blood supply of one of your muscles; but don't worry, you won't miss that muscle too much. It’s then tunneled under the tummy tuck skin to the missing breast area, to fill in the area where there is missing breast. The skin of the tummy is then lowered down almost like a window shade and the belly button is then brought out through a new button hole and the TRAM flap is then sculpted into the right shape and size and the skin is closed.

Many women ask if they can have the tissue taken from another area. You can, like from the back or even the back side, but there are some downsides to those other areas. The best benefit of the TRAM is that it makes a new breast shape using your own tissue and it doesn't require an implant to give you that volume lost from mastectomy. Women studied who have had TRAM breast reconstruction were the most satisfied with the cosmetic outcome of their breast and even years later, were happy that they underwent the procedure because of the effects it had on their flatter tummy area and their breast shape considerations. Certain risks, as with any surgery, have to do with flaps in general, namely smoking and obesity and blood supply that may affect the size and shape of the reconstruction. Those will all get discussed with you at the time of your consultation.

When I am meeting with a woman initially to discuss breast reconstruction, she may have just recently found out that she has cancer. As you would expect, her primary focus is on survival and thriving after the cancer. That is one of the very reasons I went into plastic surgery because I can be the careful steward of your decision making process, including whether you choose to do implant reconstruction or do no reconstruction at all. Sometimes you may want to wait until your need of radiation and chemotherapy are decided before you make the decision to have reconstruction. But we do know for sure, that the desire to look normal does not compromise your survival or interfere with cancer spreading. That has been studied extensively. The mind-body connection of looking and feeling well is an important one. TRAM breast reconstruction puts you on the pathway by making you feel natural and beautiful.

Breast Reconstruction after Breast Cancer

Dr. Paul Vanek discusses the TRAM Breast Reconstruction after mastectomy due to breast cancer.