title: Immediate transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction in underweight Asian patients.
abstract: BACKGROUND
  TRAM breast reconstruction is commonly thought to be inadequate for underweight patients and LD flap with implant is usually recommended. However, it is often difficult to find an appropriate implant for thin Asian women with small breasts. The authors present the results of using TRAM flap alone for immediate breast reconstruction in underweight Asian patients.
  
  
  METHODS
  Between September 2001 and October 2006, 564 patients underwent immediate TRAM flap-only breast reconstruction. Among these, 18 were underweight (BMI <18.5 kg/m(2)) and 317 were normal weight (18.5 kg/m(2) ≤ BMI < 23.0 kg/m(2)). Complications were classified as systemic, breast, and donor site. Complication rate, oncologic outcome and overall satisfaction and recommendation were compared between two groups. Standardized postoperative photographs were also subject to a panel for cosmetic assessment.
  
  
  RESULTS
  the overall complication rate was 22.2 % in underweight group and 27.1 % in normal weight group (p = 0.32). There was a tendency that the breast complication rate was higher in the normal weight group and the abdominal complication rate was higher in the underweight group. However, neither of these was statistically significant. Mean satisfaction was not statistically different, either (8.44 vs. 8.60, p = 0.54). Panel assessment for overall cosmesis, symmetry and scarring showed no significant between-group differences.
  
  
  CONCLUSIONS
  Immediate breast reconstruction using TRAM flap alone can be performed with acceptable complication rates and comparable patients' satisfaction score in a well selected underweight Asian women as in a normal weight group.
authors: Department of Plastic Surgery, Asan Medical Center, University of Ulsan, Pungnap-2 dong, Songpa-gu, Seoul, Korea.
authors: Eun Key
authors: EK
authors: Kim
authors: Jin Sup
authors: JS
authors: Eom
authors: Chang Heon
authors: CH
authors: Hwang
authors: Sei Hyun
authors: SH
authors: Ahn
authors: Byung Ho
authors: BH
authors: Son
authors: Taik Jong
authors: TJ
authors: Lee
mesh_terms: D000328:Adult; D044466:Asian People; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D017568:Rectus Abdominis / Q000601:surgery*; D013524:Surgical Flaps; D013851:Thinness; D016896:Treatment Outcome