The below question is answered by the Charleston breast surgeons at The Center for Natural Breast Reconstruction.I had TRAM flap reconstruction(opens in a new tab) in 2002 with revision and a follow up surgery in six months later. Since then some shrinkage has occurred in the reconstructive side and I have a hollow area on the upper portion. Do I have options for more normal looking breast without the hollow area? You potentially have many options to improve your reconstruction(opens in a new tab). No one solution is perfect for all situations, but some options include repositioning the flap to a higher location, augmenting the hollow area with your own fat grafts (taken usually from abdomen, thigh, or buttocks), or using any excess skin / fat from under your armpit as an additional flap to lift and augment the TRAM (we call this a 5th intercostal artery perforator flap). Some more aggressive options would include placing a small breast implant under the TRAM flap, or adding a whole new microvascular flap from another area, although this is rarely in practice necessary. Hope this helps. Please feel free to email(opens in a new tab) or call with any additional questions. --The Center for Natural Breast Reconstruction Team