How is a DIEP flap different from a TRAM flap?

The DIEP and TRAM flap use the same skin and fat from the lower abdomen, but the TRAM flap will remove the six pack muscle from the abdomen. The DIEP flap separates the blood vessels from the six pack muscles, leaving the muscle in the abdomen. Sparing the muscle with a DIEP flap leads to less pain, quicker recovery, and less risk for hernia after surgery.