Regret or Delight? Would I Have TRAM Surgery Again?

Finally well enough to go camping

I feel well enough to go hiking near one of our favorite camping sites.
I feel well enough to go hiking near one of our favorite camping sites.

Fifteen weeks later, would I do it over the same?

Recently, someone asked me if I am happy with the outcome of my recent TRAM Flap breast reconstruction surgery and if I would do it again. Well, Kathy, actually, I'm glad I did it. It's been more than three months since I had my prophylactic bilateral mastectomy and TRAM Flap reconstruction and I must say, as difficult as the recovery was the first month, I would do it the same way again. (Of course, what else am I going to say at this point?)

Still, this surgery was a good solution for myself and my situation. After having tested BRCA positive, I knew I would be removing my breasts due to my high chances of getting breast cancer--my sister has had breast cancer twice and our grandmother and aunt both died from this monster. Choosing the type of reconstruction was a bigger decision for me. My sister was given far less options than I.

Even now, there are times when I really notice the movements/activities I can't do yet (lifting, etc. that take strong stomach muscles). I've been told it takes about a year to really get back to normal. For instance, while camping last week, we took some hikes that had some hills to climb. Halfway up the hill, I was holding my stomach. It's not that holding my stomach did anything to really help, it just seemed like it helped as I felt the muscles dramatically tightening as I stepped up the hills. Whatever...I was just glad to get out of the house and away to one of our favorite campgrounds.

Still, this surgery was a good choice for me. As bad as this sounds, it's a good "lazy" way out of having to find prosthetics, dealing with ongoing implant maintenance, and more. Being a mom of two young kids, I don't have time for repeat surgeries, etc. It was done and I can move on. And what the hell...I got a much-needed tummy tuck out of the deal.

But there are times when I look in the mirror at myself and wonder how I could have mutilated my body this way. It's been a relatively short time that I've had these new breast shapes, and yet, I have trouble remembering what my old, saggy "mom boobs" looked like before I received this perkier pair. I also "get" the crude slang term for breasts: "headlights." The circle scars left on my breasts, absent nipples or areola, really do look like headlights on a car. I suppose that's my way of laughing at myself. If I didn't find something funny in my situation, I'd likely go nuts and slit my wrists or something. I figure, it is what it is.

And fuck it! I made my choice and now I get to live with it. Yes, I get to live, and more importantly, I don't have to worry as much as I had been about getting cancer. Even my kids have gotten used to the whole new tit thing and think nothing of seeing mommy walk around nude with my scars and new breasts hanging out.

I do have a friend who had the TRAM reconstruction and while she says she's glad she had this type of breast reconstruction, she also says she can't look at her naked body in the mirror because of all the scars the surgery produces; it's too upsetting. Regardless, she's glad for the tummy tuck and how she looks while clothed.

In other words, as much as I hate repeating the surgeons' favorite line, everyone is different and will react differently to their outcome. (It doesn't hurt to have an excellent plastic surgeon.)

In Kathy's case--having a flat chest after her bilateral mastectomy and trying to find comfortable breast prosthetics--I am sympathetic to your situation after having watched my sister's discomfort when her second breast was removed. After her expander became infected and had to be removed, she was left with one absent breast. I noticed she hunched over more and repeatedly pulled her shirt away from the sensitive skin of her absent chest because of her discomfort and the way she felt having a missing breast.

Even though I had TRAM reconstruction and my sister has implants, there's something else we have in common you may consider. It always feels like we are wearing a bra. It's the way the skin pulls at the base of the breasts and across the chest (especially for her) that makes it feel this way. Having been a woman who would remove my bra upon returning home, sometimes I find myself instinctively reaching back to unlatch my bra when I walk through my door only to be reminded, there is no bra to unlatch. This tends to be frustrating because it feels like I can never relax the skin of my breasts. I'm told this gets better with time.

So, should you--Kathy or anyone in the breast reconstruction boat--have this type of surgery? It can be a good solution if you don't mind the recovery time, the scars and the long-term effects of moving muscles around in your body (you won't be doing as many, or any, sit ups in the near future...oh, darn!).

Kathy, and other breast reconstruction patients, I wish you the best of luck in choosing your favored reconstruction. Just remember, when you are so confused about your options and can't make up your mind, you can always try what I did..."everyone vote," I told my family at one of the pre-op appointments. Even the doctor raised her hand for the TRAM Flap surgery. It didn't matter. I think I already knew what I would do, I just needed some positive reinforcement so I knew I wasn't crazy for choosing such a barbaric surgery.

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Comments 11 comments

mom 7 years ago

Very good article. After seeing what your sister is going through you were right in doing it this way.


Jane 6 years ago

I am scheduled for a mastectomy with tram flap and a revision to my other breast that was reconstructed in 1985. It's a little scary, well, no, it's a lot scary. The recovery seem so brutal.

I too have the BRCA gene. But I have also had breast cancer twice before and don't want it a third time.

Your blog has been very informative. Thank you for taking the time to post all the pictures etc.

Jane


Joelle Burnette profile image

Joelle Burnette 6 years ago Author

Jane, I'm glad you've found my stories useful. I know this process is incredibly frightening, and surely, I haven't been through what you have, but you CAN get through this. The body is an amazing machine when I think of how relatively quickly it healed...the skin quickly, the rest a little slower. And mentally, more and more it was the right thing to do. I have been meaning to write more about the recovery as of late, but I am preparing for my son's bar mitzvah weekend in January and I'm swamped with everything associated with that huge event--if only my relatives would figure out what RSVP means.

I'll be writing more on the longer-term recovery issues ASAP. Just a few quick notes...sitting up is more difficult; more than seven months later, I still have difficulty lifting heavy things; I still get tired more easily; stretching my arms above my head is still limited, but easier than before (with less pain); having a numb stomach is strange; and the phantom nipple issue still pops up every so often (excuse the punn).

Please let me know how your surgery goes.

Good luck!

Joelle


Elaine 6 years ago

My mother is going in for a tram flap next month and I've been searching for information and candid stories all over the place. Not only did I find your experience very helpful, but gave me such optimism for my mother. Your story humbles me, and makes me want to applaud you and all the women that battle with cancer. Stay beautiful and strong !!


Joelle Burnette profile image

Joelle Burnette 6 years ago Author

Elaine,

I'm glad you have found my story helpful. I wish your mom the best of luck with her surgery and a quick recovery. It's a difficult process, but she can get through it. I don't know if she wants to watch my video diary, but please, don't make her watch it unless she wants to. I had my own mini nervous breakdown after seeing the photos of women with their various scars and I wish I hadn't watched it prior to my surgery. It's all so much to take in and I didn't have to deal with chemo like too many women must.

Please let me know if she'd like to chat. I'd be happy to speak with her.

(Sorry it took so long to get back to you...just started a new job writing a blog for the Press Democrat)

Thanks again for reading. I'll be posting an update very soon.

Joelle


Michele 6 years ago

Hi Joelle,

Thank you for posting your videos and info. I also have started a blog about my preventative mastectomies, but don't have as much early info as you do. At first I was glad that my husband didn't film me in the hospital, but now I wish I had that to look back on, to see how far I've come. I know exactly how you felt when you first tried to sit up, I've never felt so hurt or alone or awful.

I agree with so much in your blog, and I would do it again as well.

I would like to hear from you, I am interested in possibly posting some of your videos on my blog. Please visit and send me an email to tell me what you think.

Thank you so much, and best in everything!


Linda CB 5 years ago

Hi I had the Tram Flap breast reconstruction surgery done in 1991 and, outside of the normal expectations following surgery, I never had any complications. I love the procedure because it gives you a natural look and feel. It's been 20 years and now the ugly disease has returned to the opposite breast. Can anyone tell me whether a tram flap can be done twice? My doctor indicated that he didn't "think" so. Does anyone know for sure?


Joelle Burnette profile image

Joelle Burnette 5 years ago Author

Hi Linda,

I don't know how they did your TRAM back in 1991, but I remember my surgeons saying the same thing, that you can only do it once. I'm not a doctor, but it sort of makes sense because of how they move your muscles around in order to supply blood flow to the new breasts formed from your belly.

There's also a way they can take the skin from your back and somehow bring it around to the front of your chest; I don't know if that is an option for you, but I suppose it might be considered an option if you don't want an implant.

I'm so sorry you have to go through this horrible process again. Please let me know how you proceed.

Joelle


Linda CB 5 years ago

Thank you so much! The option about taking the muscle from the back is one of the options explained but I'll know more on Friday after consulting with the plastic surgeon. Thank you again and I will keep you posted!!!


Joelle Burnette profile image

Joelle Burnette 5 years ago Author

Linda,

Let me know what they say about the impact it could have on your back, muscle strength, etc.

Where are you having your surgery done?


Joan 4 years ago

I had TRAM surgery with a bad outcome. I would never encourage anyone to go through it. It weakened my abdominal wall so bad that I can not even have a BM without taking a laxative twice a day. They tried to fix it with a ventral hernia repair mesh implant 7 months after.. another 5 days in hospital... but it didn't ease my symptoms at all. The breasts are different sizes but that is the least of my problems. I never realized how much your abdomen does for you until I didn't have use of it. Mine is probably not the normal course but every day for 2 1/2 years I feel uncomfortable and have an abdominal bulge that wasn't there before the surgery.

The surgery itself is very painful. I required 2 units of blood and 7 days in hospital. Wrong decision for me for sure. I didn't want something foreign in my body... but I have lots of mesh in there now. I'd go for implants if I had to do it again. The tummy tuck portion can go wrong with life long consequences.

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