Bilateral breast reconstruction in very thin patients with extended free TRAM flaps.

A lateral extension of the free TRAM flap design is described for use in unusually thin patients who desire bilateral autologous tissue breast reconstruction. Because of the exceptionally good blood supply to the free TRAM flap, the lateral extensions are viable even when the flap is folded double to increase its thickness and projection. To increase the volume of the reconstructed breast, the flaps can be extended as far laterally as the surface of the operating table will permit. With this approach, bilateral TRAM flap breast reconstruction is possible even for extremely thin patients.