Hi gma. What builds the breast is the fat that is removed. If a woman has a skin-sparing mastectomy, the breast is opened, the breast tissue is removed and then the fat is taken from the tummy and put inside of the breast envelope, which leaves the breast so normal looking. Of course, the areola and nipple are removed in the majority of the cases, but it is recreated at stage 2. When a woman has had the entire breast removed and has delayed reconstruction, the docs reopen the scar and insert the fat from the abdomen plus an eliptical section of skin that they suture all around, that bridges the area that had been removed. The nipple and areola are once again created at stage two.
The size of a women's new breast, with DIEP, depends on the amount of fat she has available. If a woman wants tripple D breasts and has enough fat to fill the breast envelope, she can have DDD's.
If a woman does not have enought fat on her tummy, the docs can take it from the butt in what is called GAP. Once again, it depends on how much fat you have to give up that will determine the size you can choose for your breast.
Even if a woman has had implants, she can still have DIEP. They actually make beautiful breast, as the skin is all ready to be filled with fat.
I do have a website that caters to DIEP-GAP info. If anyone is anticipating DIEP or GAP reconstruction, feel free to visit and ask questions. It is a new site. Everyone there has either had DIEP or GAP or is on the way to surgery, or is seriously thinking about it. www.nolasociety.org Take care of you.
Cindy