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Introduction: Although DIEP (deep inferior epigastric perforator) is the gold standard for breast reconstruction, long-term results with a view to postoperative hairiness and flap skin colouration have rarely been described in the literature., Methods: Patients who underwent DIEP flap breast reconstruction followed by NAC reconstruction between 2010 and 2019 were invited to our clinic for a survey and a clinical examination. A total of 781 patients were invited. The survey included the BREAST-Q and a study-specific questionnaire. The clinical examination contained specific measurements regarding postoperative hairiness and skin colouration., Results: A total of 179 patients were examined, with 203 breasts having been reconstructed. Only breasts with a visible flap skin island were taken into further evaluation. A total of 109 DIEP flap and 77 NAC reconstructions were evaluated. In the patient-reported survey, 27.5% (30 of 109) reported additional flap hairiness and 62.4% (68 of 109) reported differences in flap skin colouration compared with the surrounding skin. The clinical examination revealed a significant difference between the skin colouration of the flap compared with the surrounding skin and the skin colouration of the reconstructed NAC compared with the existing original NAC. In both cases, the reconstructions appeared significantly "lighter" (p<0.05). No significant difference was found between patients with and without hair in terms of overall satisfaction evaluated by using the BREAST-Q. Neither did the colour difference have a significant influence on patients' satisfaction., Conclusion: Additional breast hairiness and different skin colouration is relevant and should be communicated preoperatively., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonfliktbesteht., (Thieme. All rights reserved.)