Recommendations for the Best Reconstructive Surgeons Who Do DIEP

No, this is not true.  A CT angiogram is very helpful in identifying the size, location and anatomy of the deep inferior epigastric perforating vessels.  

By looking at the study, the DIEP flap surgeon should be able to have a good idea if you are a candidate for a DIEP flap, SIEA flap, muscle-sparing free TRAM flap, or not a candidate at all.

I hope this helps.

You can usually find a small number of plastic surgeons in a major city, often times at an academic medical center, who perform the DIEP operation on a regular basis.   Having a microsurgery fellowship means that the plastic surgeon spent an additional year performing high volume, complex microsurgical cases.  Very often, these reconstructive microsurgeons are members of the American Society for Reconstructive Microsurgery (ASRM) in addition to ASPS.

It is very rare when a DIEP cannot be performed, but it is ultimatley an intraoperative decision as to whether you end up with a DIEP or some variance of a TRAM.   New imaging modalities with CT Angio or Duplex ultrasound can help "map" these vessels and delineate the anatomy better, but there is no guarantee.   Your surgeon will always perform the operation that best suits you and your anatomy, to give you the safest and best result.