TRAM flap is one method of autologous reconstruction.
The skin, fat, and muscle of the lower abdomen are used to
create a breast mound. Two incisions are required: one for the
mastectomy and another from hip to hip to obtain the tissue
for the flap. The flap may remain attached by a pedicle to its
blood supply. The pedicled flap is then tunneled under the skin
to the mastectomy site. It also may be moved as a free tissue
transfer. The entire rectus abdominis muscle is used in the
pedicled TRAM flap, and blood is supplied from the epigastric
system of the internal mammary vessels.