The deep inferior epigastric perforator (DIEP) flap was first described in 1989 by Koshima et al. The DIEP flap is a fasciocutaneous flap from the lower abdominal wall that is supplied by the perforator branch from the deep inferior epigastric artery (DIEA), which is one of the two superior vessels of the rectus muscle. The perforating branches pierce the rectus fascia to supply the abdominal fat and skin. The DIEA and the accompanying veins are pictured in the illustration entering the muscle below the junction of the middle and lower third of the muscle. There often is symmetry with the contralateral vessels, however, this is not consistent. The difference in blood supply areas—zones I, II, and III—are safe blood supply areas. In contrast, zone IV is most susceptible to reduced arterial pressure due to increased distance from the pedicle and carries the highest risk of necrosis.