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For some women, flattening their tummies while they are augmenting their breasts would be the ideal scenario. And, indeed, stomach tissue is often used in cosmetic surgery of the breast, although most often in reconstructive surgery following a mastectomy. A TRAM (Transverse Rectus Abdominis Muscle) -- a flap of skin, fat and muscle from the lower abdomen -- is transplanted into the breast region. The recipient receives a new breast and a tummy tuck at the same time. The advantage of a TRAM procedure is that it creates a natural breast ‘mound' that will change in size according to any future weight gain or weight loss. Having both procedures at the same time may increase the patient's time in the hospital and recovery time.