This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question. Question: I had a lumpectomy with radiation in 2005. Then in 2009, I had a double mastectomy with a tram flap done on the side that had the radiation and an implant on the other side. I have alot of necrosis under the arm on the side of the tram flap. It's hard as a rock. Can the necrosis be surgically removed since it's been over 5 years? I was told no by my PS. Also, I get cramping in the tram flap breast. What would be causing that? Answer:Yes, fat necrosis can definitely be removed. Removing it may make the breast smaller but it is probably a good idea to remove it regardless. Fat grafting could be done later to add more volume if needed. If you feel the TRAM breast cramping it could definitely be the muscle in the flap. Thanks for your question.

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