Karen,
I just had a single Tram Flap done in January and am recovering quite well. It was tough for the first few weeks, but well worth it. The hardest part was not being able to stand straight and that does take several weeks. I honestly don't know if I have the mesh, but think I do. I asked the surgeon about it before hand and he said he would probably use it. I don't feel anything. I do, however, have a bulge where the muscle and fat was tunneled through to the breast area. My surgeon said he might be able to make some adjustments later when I have the nipple done. I am most likely going to have a lift/reduction on the other side at the same time as the nipple.
Annette (Desertdreaming) had a bilateral tram done several years ago and she told me she cannot get up out of bed without rolling to the side. So, the muscle is definitely missed.
If you have any questions, I'd be happy to answer them. I don't post as much as I used to, but will keep an eye out.