DIEP flap reconstruction is a common method of reconstruction. Occasionally the lower abdomen does not have sufficient tissue for a bilateral reconstruction and the flap reconstruction can be augmented with mammary prosthesis. Typically, we wait until one year after a DIEP flap reconstruction to augment the breast. The satisfaction rate is high with augmentation of the DIEP flaps because the soft tissue characteristics of the breast have been returned close to normal. This yields a natural appearing augmentation post breast reconstruction.