18 months post op , what could be causing sharp and transient DIEP donor site pain?

Thank you for your question. Sharp and transient pain around the scar is likely associated with nerve pain, though it is difficult to distinguish without a proper physical exam. Significant pain may indicate keloid scarring for which a steroid injection may be beneficial. Massage can also be helpful for scar management as it promotes circulation and may help break down scar tissue. I recommend following up with your surgeon to ensure your concerns are addressed. Hope this helps!