Is DIEP my only safe option for reconstruction if I have had previous radiation?

Breast reconstruction can be either autologous (using your own tissue), or alloplastic (implant-based). It is true that after radiation, the safer way to go is most commonly autologous. However, there are some cases when radiation changes to the skin are minimal in which implants may still be an option. One of the biggest issues with using implants after radiation, even if everything goes well without complication, is maintaining adequate symmetry over time because both sides will act and age differently.The DIEP flap is a great option and is performed several times a week at many big institutions, but it is not the only option for autologous reconstruction. A more traditional option is using the latissimus muscle and skin from the back to replace the radiated skin, but an implant is usually still required under the flap. If you want to avoid the issues with using an implant after radiation, the DIEP is probably your best bet, but definitely not the ONLY option.