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When the breast has been removed for cancer and the remaining skin on the chest has been radiated the optimal choice for autologous reconstruction is to use tissue from the lower abdomen.The deep inferior epigastric artery perforator flap or DIEP flap is a variation of the TRAM flap. The DIEP flap allows the plastic & reconstructive surgeon the opportunity to utilize the skin and fat from the lower abdomen while attempting to spare muscle.The end result is that the mastectomy defect can be reconstructed and the patient can have the lower abdomen contoured.

Typically, after DIEP flap reconstruction, patients will return for a second stage of their operation for additional symmetry as well as any revision of the abdomen, such as liposuction or scar revision. The third and final stage of the reconstructive process is the creation of a nipple areola complex on the reconstructed breast. Often patients may say that they do not need a nipple areola reconstruction and are satisfied with the overall improvement in contour and feel more comfortable in a bra or in clothes.