Reconstrucción mamaria con colgajo músculo-cutáneo transverso de recto abdominal [TRAM] y simetrización simultánea

Abstract

Scientific reports analyzing the outcome of postmastectomy with simultaneous symmetrization of the opposite breast are scarce. The purpose of this study is the analysis of the experience with breast reconstruction with the pedicled transverse rectus abdominis myocutaneous (TRAM) flap and simultaneous symmetrization with opposite mammoplasty, at the Cátedra de Cirugía Plástica y Quemados, Facultad de Medicina de la Universidad de la República, Montevideo, Uruguay. A retrospective review was performed on 5 patients. Mammoplasty technique used was either mastopexy or breast reduction, with superior or inferior based pedicle, always with the T-inverted incisions. The contralateral mammoplasty was performed simultaneously with either the mastectomy in those cases where simultaneous reconstruction was performed, or the abdominal flap elevation in case of delayed reconstruction. The retrospective review was realized considering the degree of general satisfaction as well as the degree of satisfaction according to specific aesthetics aspects. High satisfaction rates were observed within the patients treated. The complications rate wasn't higher than the one mentioned in international literature for breast reconstruction without symmetrization. Time for patient recovery was always less than two months. We conclude that breast reconstruction with TRAM flap and simultaneous symmetrization with opposite mammoplasty achieves good long terms results, decreasing the volume requirements for the abdominal flap, with no increase in either morbidity or surgical time. The need for complementary surgical procedures is also decreased.