I have encountered several cases that have had prior TRAM flaps for breast reconstruction.  I initially feared that I would jeopardize the vascular blood supply by making my Mini Mitral incision on the upper or lower aspect of the TRAM flap incision.  After consulting with one of our plastic surgeons, he felt that it would not be a problem.  I have enclosed 2 pictures of Mini Mitrals where the incision was made on the superior and inferior aspects of the TRAM flap incision.

So in Conclusion, this is not a contraindication.