Efficacy and safety of immediate breast reconstruction with DIEP flap

Immediate breast reconstruction with deep inferior epigastric perforator (DIEP) flap is one of the most widely used autologous techniques in post-mastectomy reconstruction, as it combines a high flap viability rate with lower abdominal wall morbidity when compared to myocutaneous flaps.This article delves into evidence of the efficacy and safety of DIEP in the immediate setting, detailing patient selection, preoperative planning, perforator mapping, essential technical steps, perioperative care (including ERAS protocols), clinical outcomes, complications, and risk factors, as well as specific considerations in the presence of radiotherapy and previous abdominal surgeries.The literature shows high rates of microsurgical success and good aesthetic and functional results, with complications that are generally predictable and mitigable through appropriate selection, technical standardization, and experienced teams.It is concluded that immediate reconstruction with DIEP is effective and safe, with significant advantages in quality of life, especially in centers with expertise in microsurgery.