ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

DIEP flap or TRAM flap

Updated on May 4, 2010

More than 254,000 women in America will be diagnosed with breast cancer this year.  If the lump is small the surgeon can perform a lumpectomy, excising the tumor and some of the surrounding tissue.  This is a breast conserving procedure, and often  no follow-up surgery  is necessary.  If  the lump is large enough that removal will leave the breast significantly misshapen a mastectomy is usually performed.  Some women are even  electing  to have both healthy breasts removed if they find they are positive for the BRCA1 gene.  This gene, only recently identified, indicates a genetic predisposition to breast cancer.

For women faced with mastectomy breast reconstruction is an important part of the total treatment plan.  If radiation is necessary doctors recommend that a woman wait to have this surgery, but for some the reconstruction can be done the same day.  Women faced with mastectomy today have a range of reconstructive options;  all of them have pros and cons. Talk to your doctor before the mastectomy to decide what type of breast reconstruction is appropriate for you. 


The most common type of breast reconstruction is a saline implant.  This is a silicon shell filled with salt water.  The implant is inserted into a pocket on the chest wall.  It can be placed in front of or behind the muscle..  This is a popular choice, but keep in mind that saline implants don’t always last the patient's lifetime, these may rupture or scar tissue may develop around the outside of the implant. 

 Tissue flap procedures are another option.  For this type of reconstruction the doctor will remove tissue from the abdomen, thighs or buttocks and use it to shape a new breast.  For the TRAM (Transverse Rectus Abdominus Myocutaneous) flap surgery fat, muscle, and skin are removed from the abdominal area and tunneled up under the skin to form a new breast.  This is a major surgery, definitely not the right choice for everyone.  The biggest drawbacks with this procedure are loss of some abdominal strength and the possibility of hernias in the area where abdominal muscle is removed.  The free TRAM flap and the muscle sparing TRAM flap are two variations of this.   Both involve a tissue transplant rather than the tunneling procedure used in the TRAM surgery.  Less of the abdominal muscle is removed in these two variations and recovery is somewhat easier.

 The DIEP ( Deep Inferior Epigastric Perforator) flap surgery is similar to the free TRAM and the muscle sparing TRAM but in this surgery none of the abdominal muscle is used.  Only skin and fat are removed and transplanted to form the new breast.  The patient essentially gets a tummy tuck at the same time as her breast reconstruction surgery, but this too is major surgery.  It requires a long as nine hours for one breast and involves microsurgery to reconnect blood vessels in the transplanted tissue.  Only a very skilled physician can do this procedure and it‘s not widely available.  Follow up surgery is needed later to shape the breast.  If there is a complication with the TRAM or DIEP flap procedure it can’t be repeated.

Thanks to the Women’s Health And Cancer Rights Act of 1998 insurance companies must provide coverage for breast and nipple reconstruction in cases of breast cancer.  This is a major life decision.  It’s a good idea to talk to a surgeon who is comfortable performing all of the above procedures before making a choice.  Today there are only about 40 doctors in the US who are performing the DIEP flap surgery so it may necessary for some women to travel to find a doctor with experience in all procedures. 



Comments

    0 of 8192 characters used
    Post Comment

    No comments yet.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)