First, breast reconstruction after mastectomy must be covered by your insurance thanks to a 1998 federal law. This is one procedure insurance companies can't successfully deny. So given the question regarding cost -- this should not be a self-pay cosmetic procedure.
Now to address your question regarding the DIEP flap. The DIEP flap utilizes the excess skin and fat that is normally thrown away in a cosmetic tummy tuck. It is like its predecessor, the TRAM flap that harvested the excess skin, fat, and muscle from the belly. However, unlike the TRAM flap, the DIEP flap specially harvests the skin and fat and spares the abdominal wall muscles. the DIEP flap is an advanced microsurgical tissue transplantation procedure.
Autologous reconstruction such as the DIEP or TRAM flaps generally can be performed without the need of a foreign body implant. Once your DIEP flap has been performed (generally > 98percent success rate), your reconstructed breast is yours to keep. It is your own tissue. There are no risks for foreign body scar tissue formation or implant failure. However, autologous reconstruction requires an incision somewhere else on your body and is more involved in terms of operative time and recovery.
There is no one perfect answer for the "best" reconstruction. It's what is right for your and your own individual goals.
