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option for reconstruction is the transverse rectus abdominus
myocutaneous flap or TRAM flap. There are several variations
of this flap: the pedicle tram, free tram, and DEIP flap.
All three utilize the lower abdomen to create a breast mound.
The advantages of this procedure are that a permanent implant
is usually not required and postoperative radiation treatment,
while again not ideal, is possible. The disadvantages of this
procedure are that it results in a large abdominal scar, portions
of the flap can become hard and may result in lower abdominal
weakness and possible hernia formation. In addition, the procedure
takes approximately 3-4 additional hours of surgery. Most
commonly a patient stays 2-3 days in the hospital and is off
work 3-4 weeks post surgery.