In viewing a lot pictures of diep flap procedures I am really confused. Why do they look so different from each other?

Hello!  Thank you for your question. Yes - you are correct in thinking that the ultimate appearance will depend on the mastectomy incision. The skin taken from the abdomen will ultimately serve to replace the skin removed. At immediate reconstruction, it would be common just to have the skin replace the areola, which was removed, if so. For delayed reconstruction, I is common to have the large skin paddle (the football-shaped flap), which was used to reach the skin removed during the initial mastectomy.  Your plastic surgeon will likely go over the appearance and incisions for the procedure. Typically, use of vessels within the chest for reanastomoses of the vessels is common. Hope that this helps!  Best wishes!

You are seeing a wide variance in scarring because there are many variables in breast cancer reconstruction.  First, some patients undergo immediate reconstruction whereas others undergo delayed reconstruction.  Often, we can achieve better scarring with immediate reconstruction.   Next, some patients require radiation therapy which can affect results.   Third, your breast surgeon will determine the best location of your scars based on the location of your breast cancer tumor.   Often, skin-sparing mastectomy techniques are utilized but this may not be possible if the tumor is large and close to the skin.  Lastly, there is variations in techniques that are out there.   So as you can see, there are a plethora of variables involved in cancer treatment which affect reconstructive results.   Please visit w a board certified PS to learn more about your options.Best wishes,Dr. BasuHouston, TX