Anterior view of pedicle TRAM flap reconstruction procedure of the right breast. The first step shows the initial incision in the lower abdomen and right breast. The second step includes the incision of muscles and vasculature. The next step shows the rotation of the flap upwards under the skin to the right breast while leaving the rectus muscle attached to its organ site. The fourth step shows the recreation of breast mass with the transferred flap. The last step shows the vasculature of the flap.