DIEP Flap The DIEP Flap is a procedure similar to the TRAM flap. DIEP stands for Deep Inferior Epigastric Perforator, which refers to these blood vessels. The tissue used to reconstruct the breast comes from the lower abdomen, as in a TRAM flap. But it consists of skin and fat only; no muscle is used. Because of this, the recovery time tends to be shorter and the abdominal wall remains strong. On the other hand, it is a more complex procedure because, like the free flap procedure, it requires microsurgery to reattach the blood vessels in the tissue removed from the abdomen to a new blood supply in the chest. Removing tissue from the abdomen means you end up with a “tummy tuck” (a smaller, flatter midsection) which many women see as an advantage to this surgery. A reconstructed breast that uses abdominal tissue feels more like a natural breast to anyone touching it, though the reconstructed breast will have little or no sensation for you. Because of its complexity, DIEP flap surgery is not available everywhere. However, our surgeons are extremely experienced in the procedure, and have helped earn Strong Health its reputation as a leader in the field.