Subcutaneous tunnels were created bilaterally between the abdominal dissection and the subcutaneous breast pockets (see unilateral TRAM reconstruction), and the flaps were passed. The skin edges were temporarily clipped to measure and mark the boundaries to be trimmed from the skin islands. Unlike the unilateral TRAM where more of the corner distant from the blood supply must be trimmed, most of the skin of the bilateral islands, each with its own blood supply, may be preserved.
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