Angela Cheng, MD

It can be difficult to tell from the angle of your photos but you may have a tuberous breast or tubular breast deformity which results in smaller deformed or long narrow breasts due to constricted growth.  Asymmetry is common in this condition.  Tuberous breast is considered a congenital deformity and occasionally is covered by insurance to correct this.  Consultation with a board-certified plastic surgeon can confirm this diagnosis.  Depending on the patient, usually these bands of tissue have to be released during surgery and an implant or expander is needed to add volume to recreate the breast mound.  A lift/mastopexy is done at the same time to correct the size and position of the nipples. 

My suspicion is that the right side where the muscle was NOT taken for the DIEP flap is actually your normal abdominal contour.  A normal abdomen is concave (sunken in) slightly above the belly button and slightly convex (curved outwards) below the belly button.  By placing mesh after removing some muscle on the left side your surgeon actually tightened this area relative to right side.  It's hard to know for sure without examining you of course but sometimes this relative "bulge" is actually a relative "tightness or flatness" of the other side.  To correct this would likely require surgery to either liposuction our some of the fat to make it look less full or reopen the incision and place mesh or sutures to tighten this side to match.  I does not appear that you have a hernia (rare after DIEP flaps).  Since some patients require fat grafting to correct slight contour issues in their breasts, your surgeon could take a bit of fat from this area.  Otherwise, insurance may not pay for correction of this abdominal contour issue as it is not considered "medically necessary".