The Rotated Bipedicled Tram Flap: Maximising Breast Projection but Minimising Donor Morbidity - A Case Report
- Author:
Norlia Abdullah
1
;
Saiyidah Adila Mohd Adib
1
;
Nur Fa’izah Ab Muin
2
;
Nordashima Abd Shukor
3
;
Suria Hayati Md Pauzi
3
Author Information
- Publication Type:Case Reports
- Keywords: Donor; invasive micropapillary breast carcinoma; morbidity; nullipara; projection; reconstruction; rotated; TRAM flap; site
- From: Journal of Surgical Academia 2026;16(1):19-23
- CountryMalaysia
- Language:English
- Abstract: The Rotated Bipedicled Tram Flap: Maximising Breast Projection but Minimising Donor Morbidity - A Case Report:Autologous breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap remains a cornerstone of breast reconstructive surgery. However, with the classical TRAM flap, it is challenging to close a large post mastectomy defect in nulliparous and/or slim women. The resultant reconstructed breast also lacks projection. This case reported a novel modified TRAM flap technique performed in a nullipara. She had previously undergone a hysterectomy and oophorectomy for endometrial carcinoma via a pfannenstiel incision. She presented with a large left breast invasive micropapillary carcinoma (ER/PR negative HER2 3+) with only marginal response to neoadjuvant chemotherapy. She underwent a left mastectomy with axillary dissection and immediate breast reconstruction. The rotated bipedicled TRAM Flap was used to close the large defect, maximising breast projection while minimising donor site morbidity.
- Full text:2026073009031056697The Rotated Bipedicled.pdf
