Although many patients are good candidates for the DIEP flap, individual patient anatomy can vary. If the abdominal wall perforators are insufficient in size, then more than two perforators should be selected to supply the flap. Performing three or more perforator dissections is risky and causes damage to the muscle, thus defeating the purpose of the operation. In this situation, the multiple smaller perforators can be safely harvested with a small cuff of muscle. This is known as the Muscle-Sparing TRAM Flap, because much of the muscle is preserved. Most patients undergoing unilateral reconstruction will not notice a difference in their abdomen between the DIEP and MS-TRAM Flap.