Failed Breast Reconstruction Procedure Leads to Paralysis and Scarring

I have had experience with this type of patient and do perform the procedure in question. There are many other options other than this surgery, such as tissue expanders and/or implants, latissimus flaps, and regional flaps. Someone of advanced age is not an absolute contraindication for TRAM flap, and I have done this procedure for patients in their 70s. But 75 is older than anyone I have done. I would strongly recommend another procedure in this case due to the impact on the abdominal wall strength. The older patient who has a TRAM flap is at increased risk for many types of complications including DVT/PE, hernia, and UTI. If the patient had any other risk factors for wound healing, like diabetes, lupus, arterial disease, history of blood clots, etc., then I would absolutely not proceed. This would fall below the standard of care in terms of surgical judgment and patient selection.