DIEP flap breast reconstruction

The most commonly used perforator flap for breast reconstruction is the deep inferior epigastric perforator (DIEP) flap. The DIEP flap uses the lower abdominal island of skin and fat and spares the rectus abdominis muscle. Although the underlying muscle must be split to dissect out the perforating vessels, the muscle itself is not included in the transfer. The deep inferior epigastric artery and vein, which provide the vascular supply for the free flap, are anastomosed to local recipient vessels, using either the internal mammary or thoracodorsal arteries and veins.