It is very rare when a DIEP cannot be performed, but it is ultimatley an intraoperative decision as to whether you end up with a DIEP or some variance of a TRAM. New imaging modalities with CT Angio or Duplex ultrasound can help “map” these vessels and delineate the anatomy better, but there is no guarantee. Your surgeon will always perform the operation that best suits you and your anatomy, to give you the safest and best result.
The best plastic surgeon for you is the one who is qualified and who understands your individual needs and presents the best options for you. I welcome you to contact our office at 415 933 8330 to discuss DIEP breast reconstruction, and/or other autologous (self) tissue options.