More breast cancer survivors are going flat after mastectomy
Add Axios as your preferred source to
see more of our stories on Google.
Illustration: Allie Carl/Axios
More breast cancer survivors are choosing not to reconstruct their chests after mastectomy and going flat instead.
Why it matters: The shift reflects a cultural change in how survivors define recovery, beauty and body autonomy.
State of play: "In years past, the assumption was you were gonna have a reconstruction," says Mary Gemignani, chief of breast surgery at NYU Langone Perlmutter Cancer Center.
- Now, there's a movement highlighting that it's OK not to have one, and patients increasingly ask for "flat aesthetic closure," she says.
- That's the term — promoted by breast cancer survivor advocacy groups like Not Putting on a Shirt (NPOAS) — for a flat chest with no excess skin after surgery.
Between the lines: Gemignani says women aren't typically going flat for athletic reasons ("I've had competitive tennis players who've had implants, and they still are able to play," she tells Axios) — or just financial ones. It's often personal preference.
- Data suggests that most patients who get mastectomy go flat, with more young people intentionally choosing that option in recent years for a faster recovery and to avoid getting tissue expanders or implants.
The big picture: As celebrities remove implants and dissolve fillers, "there's a trend toward embracing your natural body," says Kim Bowles, president and founder of NPOAS.
- Even in the breast augmentation space, women are choosing smaller breasts.
Zoom in: Bowles, a breast cancer survivor, said reconstruction didn't appeal to her — even though she was a candidate for DIEP flap surgery, which uses belly tissue to build new breasts.
- "I just wanted to get back to life with my toddlers," she says.
- Going flat allowed her to avoid a major surgery and recovery, and embrace the "freedom" of being bra-less. (But flat bras are also a thing.)
Bowles had a double mastectomy in 2017 and asked to go flat. She said her surgeon ignored the request, leaving extra chest tissue "in case you change your mind," she recalls him telling her.
- She now works to prevent what she calls "flat denial" — when surgeons disregard patient preferences.
What she's saying: "Just because you lost a couple of bags of tissue on your chest, it doesn't make you less of a woman."
Go deeper: Tattoos help breast cancer survivors heal
