Why get new ones? The real ones tried to kill me! It is assumed most women want to look like they did before their mastectomy. That may be a myth. According to research published in Jan. 2021, by the journal Annals of Surgical Oncology, nearly 75% of women surveyed who opted for mastectomy without reconstruction were satisfied with the results. Another study published in October 2014 in the journal JAMA Surgery revealed that just 42% of women chose reconstruction after mastectomy. But, whatever the choice, reconstruction or not, 87% of women were satisfied with the decision they made.

There are several reasons a woman may choose to not have reconstruction surgery.

  • Not wanting more surgeries
  • Wanting to be finished with treatment
  • Wanting to end pain
  • Concerns with cost if no health insurance
  • Concerns of Recovery time
  • Fear of implants

What is going flat? Going flat is opting not to have reconstruction surgery after the mastectomy.  If this is your choice, please emphasize it to your surgeon.  I have read many articles and studies of surgeons who have assumed that women prefer to look like their pre-cancerous self.  Many women do not receive ALL options available including no reconstruction surgery.

When women choose to go flat, they are usually left with unsightly skin flaps, extra tissue, skin puckers, and other “defects” leaving the mastectomy site not smooth and flat.  The responsibility is on you to express your wants to your surgeon and plastic surgeon.


According to numerous websites, there are steps you can take to make sure you are heard and to protect your choice.

  • Communicate Your Decision clearly with your surgeon: “Aesthetic Flat Closure
  • Do your research. Show surgeon pictures of what you want and discuss what you don’t want. Use the “Flat is Beautiful” brochure to find pictures you like to share. There is also a guide that list questions to ask your surgeon
  • Use a surgeon with a record of high-quality aesthetic flat closure: ask to see pictures of past procedures
  • Use your instinct! If it doesn’t feel right get a 2nd opinion
  • Reflect on Your Surgeon’s Response
    • If there’s any pushback, it may be time to consider a new surgeon.
    • The surgeon needs to accept and respect your decision
  • Ask surgeon if she is willing to work in-tandem with a plastic surgeon to get the results you want
  • Document your choices, photos of what you want and don’t want, and ask for them to be put in your medical record
  • Ask your surgeon to confirm in writing your discussion (email is fine). Be sure to include the term “aesthetic flat closure.”

If you have any anxiety or questions about this surgeon’s work, find another surgeon.  You deserve a beautiful outcome.

Take the steps to ensure a lovely result!