To answer your question, I believe they always make the breast a little big so that they have room to go back and "sculp" the breast to what they want. Yes this can involve liposuction in some cases. I had my DIEP 2 years ago and could not be any happier. I love my new breast and you would never be able to tell the difference just by looking at me. I have not had any problems and new breast feels very natural. The recovery time is about the same but a lot less involved and is done as an out patient proceedure. I had my surgeon do extra lipo on another part of my body while I was there. My surgeon constructed my nipples in his office a few weeks later after the swelling went down. There is no feeling in the area so there was no need to use anesthesia and I watched him perform the proceedure.
Good luck to you and hope you enjoy your new breast(s).
Teresa