The DIEP flap, or deep inferior epigastric perforator flap, uses skin and fat from the belly, but does not involve cutting any muscle. The benefit of this technique is that there is no abdominal weakness or potential for hernia. This is a more complex technique, in that it involves microsurgery to attach the blood vessels (inferior epigastric perforator) to the blood vessels in the chest.
Finally, the latissimus dorsi flap involves recreating a breast using muscle from the back. This is generally well tolerated, and recovery time is shorter than a reconstruction using abdominal tissue. Since many women don’t have a large back muscle, sometimes this procedure is combined with an implant to give the size, as well as feel of a real breast.