I chose implants because I was told DIEP Flap was more akin to an organ transplant than anything else and a more serious procedure (that, and there really isnt much 'meat' on me to take anyway). The only peer I chatted with who had DIEP was really unhappy with the whole experience, including the outcome. I don't think it's at all safer or better than implants from most perspectives, besides the idea of having something foreign in your body, that is! All the paperwork they showed me on breast implants (there was a basic info booklet thing that I think everyone gets) - shows there's something like a 40% satisfaction rate with implants and even uglier percentages for those that require some type of revision. I don't think the look would be any more or less 'natural' depending on if the 'breast' is crafted from your own parts or from silicone - what did doc say about that? (I find it surprising that they'd say DIEP looks more natural, that doesn't seem right to me ) It seems silicone might have the chance to be more 'breast' shaped with form, symmetry, and smoothness. I wonder if doc can give you a 'satisfaction rate' for DIEP in comparison to implants. I died on the mountain to keep my nipples, and believe that I was pushed toward implants when that really was not right for me. They ultimately failed and needed to be removed, and what's left is so much scar tissue that the nipples are really dumb looking and hard and permanently smashed weirdly like raisins anyway. I believe I'd have been happier surrendering the nips, going flat with mindfulness toward aesthetics and smoothness, and having tattoo nipples, instead. I know you asked for those that DID ultimately do DIEP, so I hope that this was helpful anyway. I'm under 50 and thought implants would be nice for a few decades, and then removed when I get to be a real old lady, but that didnt work after all. I could still try implants again, but I'm still really holding on to anger toward the doctors and feeling like implants are so expensive and risky anyway. I wished there were a better option... Only after it was too late did I find "Flat Denial" was something I was surely a victim of - where I told my providers that I didnt really need 'breasts', I just didnt want to be concave or have odd scarring or lumpy/unnatral profile - they said that those weren't real procedures (tissue rearrangement, fat transfer, nipple-sparring when going flat, mindfulness toward scarring, preventing concave look... ) But they ARE!! It just wasnt until my breast implants were already failing that I learned this.