When to assess the DIEP flap perfusion by intraoperative indocyanine green angiography in breast reconstruction?

•In most cases the ischemic area was the same on donor and recipient sites.•When there are differences, the well perfused area was larger at the recipient site.•Risk factors were bilateral flaps, lateral perforator vessels and tobacco use.•Performing ICGA on donor site to assess perfusion of flaps has several advantages.