Before and after abdominal revision in a 63 year old breast cancer survivor who underwent bilateral TRAM flaps for breast reconstruction 30 years ago. Due to her TRAM (transverse rectus abdominis myocutaneous) flap harvest, she had lost both rectus abdominis muscles and the overlying fascia and had an obvious hernia and bulge of her abdominal wall.
The TRAM flap was “state of the art” 30 years ago; now we only offer abdominal muscle-sparing procedures such as the DIEP flap and SIEA flap! She was unable to keep her abdomen flat and had physical discomfort related to her loss of abdominal wall competence. She had preexisting scoliosis which accentuated her asymmetry and deformity.
Her abdominal hernia/bulge was repaired by using the same lower abdominal incision, but with the objective of lowering the scar to a more aesthetic location lower down on her abdomen. Her bulging abdominal wall was tightened in all dimensions to create a more flat contour to her belly. Permanent firm mesh was placed over the abdominal wall to reinforce its closure. Liposuction completed the procedure to create the most aesthetic contour to her abdomen.
Follow up photos are shown at two months after surgery. She is still wearing her abdominal binder for comfort and to assist with resolution of her surgical swelling, still evident in her skin. She has started scar therapy and has returned to the trails to hike each day with her dogs. Her abdominal contour is greatly improved!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
