A TRAM flap breast reconstruction uses your own abdominal tissues to construct a new breast. During a TRAM (for Transverse Rectus Abdominus Myocutaneous) flap procedure, the breast is reconstructed from muscle, skin and fat. Although the TRAM procedure can mean a longer procedure and a longer recovery period, it may be the best option for women who’ve undergone radiation therapy and who are not good candidates for tissue expansion. It may also offer more symmetrical results for some patients, depending on body type and other variables.