Breast Reconstruction Surgery

Davinci plastic surgery | Washington dc | steven p. davison, md

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

TRAM FLAP BREAST RECONSTRUCTION
Transverse Rectus Abdominus Myocutaneous Flap

The Tram Flap is the most common form of living tissue breast reconstruction used today to recreate a natural looking – warm - soft breast…

Advanced – refined techniques and microsurgical technologies used today - enable women to recover more quickly & lead normal, happy lives. We believe in tailoring breast reconstruction to each patient using the best technique – and your own living tissue or implants.

Tram Flap breast reconstruction includes two main types of procedures – pedicled flap and the free flap procedure.  In each technique, a portion of skin, fat, and muscle is removed from the lower abdomen and transferred to the chest (mastectomy site).  These living tissues are then used to create a new breast mound.  Like the tissue removed during a tummy tuck – the tissue taken from the abdomen during a Tram Flap procedure is very similar.  The Tram Flap procedure can be either pedicled - meaning  it remains attached to its blood supply or it can be a free flap - which is detached from its original blood supply and reattached to a blood supply at its new location. Two scars are created during Tram Flap procedures – a horizontal abdominal scar that runs from hip to hip - and an elliptical shaped scar on the breast. Breast Reconstruction can be performed at the time of the mastectomy - under the same anesthetic - allowing you to wake up with a breast mound in place – or it can be delayed and performed later after you are recovered from your mastectomy and other treatments.  

 Dr. Davison has years of specialized training and extensive experience in breast reconstruction surgeries. By combining meticulous skill and the supreme elements of art and surgical science - His patients enjoy results that are functional – attractive and natural looking.

Benefits of TRAM Flap Breast Reconstruction:

  • TRAM Flap is today’s most commonly used flap reconstruction technique
  • TRAM Flap uses living skin, muscle & fatty tissue from the lower abdomen
  • TRAM Flap reconstruction can be done effectively right after mastectomy surgery
  • TRAM Flap achieves a tummy tuck as part of the procedure
  • TRAM Flap often results in improved abdominal contour
  • TRAM Flap requires no exposure to synthetic breast implants
  • TRAM Flap can be ideal when other alternative methods have failed
  • TRAM Flap surgery requires meticulous skill - knowledge – experience to achieve natural looking results

WHO IS A GOOD CANDIDATE FOR TRAM FLAP RECONSTRUCTION?

TRAM Flap reconstruction is an excellent choice for many patients. It could be an ideal choice for you after a mastectomy – or if other methods have failed. It is a good choice if tissue expansion is unsuitable due to radiation, if there is insufficient skin left at the breast site after surgery, if you have large droopy breasts and/or if large areas of breast tissue have been removed during a lumpectomy. It is also a great technique if you already have a scar from a C Section or Hysterectomy. Dr. Davison can determine this during your personal consultation. You should also be in otherwise good health, should not smoke, and you must have realistic expectations.

During your consultation -Dr. Davison listens carefully - as this time is critical to developing a clear understanding of your concerns & building a relationship with you.

TRAM FLAP PROCEDURE:

There are two types of Tram Flaps: 1) Pedicled – the blood supply is left intact while the skin, fat and muscle are tunneled to the breast site, 2) Non-pedicled – the vessels are detached from their original blood supply and then reattached once the entire flap has been moved to the breast site. After you are anesthetized – under general anesthesia so you are asleep during your surgery - these are the steps involved in TRAM Flap surgery:

  • Microsurgical techniques and technology are employed
  • Skin, fatty tissue and muscle are transferred to the chest – if needed the blood vessels are connected to vessels at the mastectomy site with the aid of a special microscope.
  • The TRAM Flap is sculpted into a breast mound.
  • A new nipple is created usually - 90 days later.
  • Pain and discomfort at the abdominal and breast sites is normal and to be expected.  Discomfort is managed with oral medication and restricted activity.  Patients typically return to modified - routine daily activities in 2 to 3 weeks and full recovery takes approximately 6 weeks.
  • Tram Flap procedures are performed in-hospital and patients typically remain in hospital for 3-5 days. 
  • Tram Flap procedures require great skill and expertise in microvascular surgical techniques.

FREQUENTLY ASKED QUESTIONS:

Where Is TRAM Flap Surgery Performed?
Dr. Davison performs surgeries in several local hospitals including Georgetown, Sibley and Virginia Hospital – the location of the latest NBCS breast cancer center.

Will Insurance Pay For TRAM Flap Breast Reconstruction Surgery?
Most breast reconstruction surgeries are covered.  Symmetry operations on the other breast for prophylactic surgeries are also usually covered.

How Long Does TRAM Flap Breast Reconstruction Surgery Take?
This varies with each patient – but it generally takes several hours.  Dr. Davison will be able to give you a time frame during your consultation.

What Is Recovery Like After TRAM Flap Reconstruction?
Recovery time varies with each patient also. Typically Dr. Davison’s patients return to modified daily routines in 2-3 weeks post-operatively with full recovery at 6 -8 weeks. It is important that you have a responsible adult stay with you after your surgery, and for a few days when you get home.

Will I Look Different After TRAM Flap Reconstruction Surgery?
You will wake up with breast mounds in place.  Healing takes time – but you will look very natural when healing is complete.  Our goal is to make the post mastectomy transition as smooth as possible.

What Kind Of Implants Will Be Used If Implants Are Needed?
Often a Tram Flap eliminates the need for implants.  

Is Dr. Davison Well Qualified To Do TRAM Flap Microsurgical Surgeries?
Dr. Davison is exceptionally experienced, skilled and comfortable in performing the latest – most advanced - microsurgical techniques for autogenous (your own tissue) breast reconstruction.  Dr. Davison has performed hundreds of microsurgical reconstructions during his career – and he performs them regularly.

WHY CHOOSE A BOARD CERTIFIED SURGEON?
When considering any surgery it is most important to know and trust your surgeon. Dr. Davison is triple board certified and fellowship trained – which means he has specialized training and experience in three subspecialties, and he has met and exceeded the rigorous standards set forth by each board.  To be fellowship trained means that, in addition to his med-school training and residencies, he has had several additional years of specialized surgical training for reconstructive plastic surgery procedures.

At DAVinci – Dr. Davison strives to provide a “patient centric” experience,
combining the supreme elements of art and surgical science.

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Steven P. Davison, MD

Steven P Davison - board certified plastic surgeon

Breast Reconstruction
Plastic Surgeon
Washington, DC and Northern Virginia

Dr. Davison is board certified and fellowship trained with a special interest in breast cancer reconstruction.  His unique and desirable skillset places him in a special league of surgeons who can provide unequaled expertise in full-spectrum plastic and reconstructive surgery.  He is able to effectively deal with other cancers as well, including melanoma and successfully manages many  surgeries of the body, both cosmetic and reconstructive.  Dr. Davison’s interest in breast and body contouring facilitates in his creation of a natural, aesthetic breast that is pleasing to the patient and grants him hundreds of happy patients.