Muscle-sparing autogenous breast reconstruction has enhanced the multidisciplinary care that is available to patients who have breast cancer. The DIEP flap has proven reliability, a low complication rate, and is applicable to many clinical scenarios (Figs. 8-12). Avoidance of muscle sacrifice in the abdomen ultimately translates into greater patient satisfaction. The increased demands, in terms of surgical expertise, are more than offset by decreased postoperative pain and decreased donor site morbidity. The methods that were used to innovate the DIEP flap have been applied to other donor sites and the available options for patients have been expanded.