The body prefers its own tissue, and, when successful, has very few complications. It can be performed at the time of breast removal. A woman receives a flatter abdominal contour at the same time the tissue is removed. A TRAM flap has better long-term outcomes than implant surgery. Because there is usually more fat below the naval, an implant can be avoided.
Hernias can occur if the abdominal wall is weakened.
Women with pre-existing conditions usually are not candidates for this surgery. However, a TRAM flap can be 'super-charged' using an operating microscope to attach some of the blood vessels in the flap to the breast area. Same as pedicled TRAM flap above. Additionally, the transferred tissue survives more completely and is more easily shaped. Additionally, a free TRAM flap is a longer procedure and requires a longer post-operative stay in the hospital.