11 Jul
When researching breast reconstruction options—especially those involving the abdomen—it’s easy to stumble upon terms like “DIEP flap” and “tummy tuck” and wonder: aren’t they kind of the same thing? It’s a common question, and a completely understandable one. After all, both procedures involve removing skin and fat from the lower belly.  But while they may seem similar at first glance, DIEP flap surgery and a “tummy tuck” are very different in purpose, technique, and outcome. Whether you’re exploring breast reconstruction after mastectomy or simply curious about aesthetic options, understanding these differences can ensure you make the right choice for your body and your journey. 

What Is DIEP Flap Surgery?

DIEP flap surgery is an advanced form of breast reconstruction that uses a woman’s skin and fat—typically from the lower abdomen—to recreate a soft, natural-looking breast after mastectomy. Unlike older techniques, the DIEP flap preserves the abdominal muscles, which helps support a smoother recovery and maintains core strength. Women often choose DIEP flap reconstruction, specifically,  because it offers a long-term, implant-free solution that feels more like their natural body. For many, it’s a way to reclaim confidence, wholeness, and ownership of their healing—on their terms.

What Is a “Tummy Tuck” (Abdominoplasty)?

A “tummy tuck”, medically known as abdominoplasty, is a cosmetic procedure that removes excess skin and fat from the abdomen while tightening the underlying muscles. It’s commonly sought by individuals—often women post-pregnancy or after significant weight loss—who want to achieve a flatter, firmer midsection. During the procedure, a horizontal incision is made low on the abdomen. The surgeon lifts and repositions the skin, tightens stretched abdominal muscles, and trims away excess skin and fat. While it can improve body contour and confidence, a “tummy tuck” is not a breast reconstruction procedure and doesn’t involve the microsurgical techniques used in DIEP flap surgery.

DIEP Flap vs. Abdominoplasty: Exploring Their Similarities and Differences

It’s not uncommon for DIEP flap breast reconstruction to be confused with a “tummy tuck”—after all, both surgeries involve the lower abdomen and can result in a flatter stomach.  But while they share some surface-level similarities, they’re fundamentally different procedures with very different goals, and understanding the differences can help set realistic expectations.

Some of their key similarities include:

  • Abdominal Tissue Involvement: Both surgeries remove excess fat and skin from the lower abdomen.
  • Improved Contour: Patients often enjoy a flatter, tighter abdominal area after either procedure.
  • Incision Location: Both typically involve a horizontal incision placed low on the abdomen, often below the bikini line.
  • Final Results/Scar Placement: Both procedures create a final scar that runs across the lower abdomen from hip to hip, which is commonly hidden under a swimsuit or underwear. 

Some of their key differences include:

  • Purpose: A “tummy tuck” is cosmetic; DIEP flap surgery is reconstructive and designed to rebuild the breast after mastectomy.
  • Microsurgery: DIEP involves advanced microsurgical techniques to reconnect tiny blood vessels and, at PRMA, restore breast sensation using TruSense®.
  • Tissue Use: DIEP transfers skin and fat to the chest to recreate a breast; a “tummy tuck” does not move tissue elsewhere.
  • Muscle Preservation: DIEP flap spares the abdominal muscles, whereas “tummy tuck”s may involve tightening or altering those muscles.
  • Surgeon Training: DIEP flap surgery requires the expertise of highly trained microsurgeons. This is due to the extensive care and technique required to properly harvest the necessary blood vessels and sensory nerves needed to successfully transplant the abdominal tissue to the chest wall for breast reconstruction. 
  • Insurance Coverage: The Women’s Health and Cancer Rights Act (WHCRA) mandates insurance providers to cover breast reconstruction surgery, including DIEP Flap. On the other hand, an abdominoplasty is considered cosmetic surgery and is not covered by insurance.
Feature DIEP Flap Surgery “Tummy Tuck” (Abdominoplasty)
Purpose Reconstruct breast post-cancer Cosmetic body contouring
Tissue Transfer    Yes (to chest) No
Muscle Preservation  Yes Yes
Insurance Coverage Yes (WHRCA) No
Performed After Mastectomy? Yes No
Additional Breast Surgery Yes No

Is DIEP Flap Surgery a Free “Tummy Tuck”?

This is a common question, and it’s completely natural to wonder. DIEP flap surgery removes excess skin and fat from the lower abdomen, and many patients do enjoy a flatter stomach afterward. However, their purposes are dramatically different. The primary purpose of DIEP flap surgery is reconstruction—to rebuild the breast after mastectomy using a woman’s own natural tissue. Additionally, unlike elective “tummy tucks,” which are performed purely for cosmetic reasons and typically not covered by insurance, DIEP flap reconstruction is considered medically necessary. 

Can You Get a “Tummy Tuck” After DIEP Flap?

While it’s not as common, some women consider a “tummy tuck” after having DIEP flap breast reconstruction, typically to address residual skin laxity or refine abdominal contour. In certain cases, this is possible, but it’s important to understand a few key considerations first. For example, even though the muscles remain intact, a DIEP Flap procedure still alters the abdominal wall and blood supply. This means any future abdominal surgery—like a “tummy tuck”—requires careful evaluation to avoid complications. If you’re exploring this option, consulting with a board-certified plastic surgeon with experience working with post-DIEP anatomy is essential. They’ll be able to assess your unique situation, prioritize your safety, and guide you toward the most appropriate course of action.

Talk to PRMA About Mastectomy Reconstruction Options

While DIEP flap surgery and an abdominoplasty may appear similar initially, they serve very different purposes. DIEP flap is a powerful, reconstructive procedure designed to restore what breast cancer took away. A “tummy tuck,” on the other hand, is a cosmetic choice focused solely on abdominal contour.  If you’re considering either procedure—or simply trying to understand your options—talking with an experienced, board-certified plastic surgeon is the best next step. At PRMA, we’re here to guide you with expertise, compassion, and a commitment to helping you make the right decision. Schedule a virtual or in-person consultation today—and let’s explore your journey together.
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3 Comment

  1. Lillie linette Dean

    I had my breast remove in 2000 i’m 67yrs is it to late to get reconstruction

    1. PRMA Plastic Surgery

      Great questions Lillie! There is no deadline for breast reconstruction and no age limit! As long as you are in overall good health, you are a good candidate for breast reconstruction!

  2. Cynthia Ramos

    This information was very helpful. Thank you.