In patients who have undergone radiation therapy, breast reconstruction with mammary prosthesis may be challenging. Often implants may become repeatedly infected or possibly extrude from the body. When repeated infections occur or if implants extrude from the body, these patients are often not candidates for implant based breast reconstruction. The most common donor site used for breast reconstruction is the lower abdomen. The deep inferior epigastric artery perforator flap can be used to reconstruct the breast with limited donor site morbidity. Satisfaction rates are high with the DIEP flap.