Getting flat after a mastectomy

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When you choose to leave one or both sides of the breast flat after mastectomy — rather than having breast reconstruction surgery with tissue flaps or implants — it’s called flattening. People who live flat live flat all the time or choose to use external breast forms as often as they want.

Doctors sometimes assume that after a mastectomy, women want to reconstruct their breasts, using either a breast implant or tissue from another part of the body (called a flap or autologous reconstruction). If your doctor doesn’t offer going flat as an option, you may need to be your own advocate and start the discussion yourself.

Current research shows that women who choose to reconstruct their breasts have no advantages in terms of quality of life, body image and sexuality compared to those who choose to go flat. 1

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Feb. 27, 2021

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If you’re thinking of going flat, there’s no good time to make a final decision. Many women decide right away that going flat after a mastectomy is the best option for them. Other women decide to go flat after having breast reconstruction surgery with tissue flaps or implants, especially if they experienced pain, discomfort, or other problems related to the surgery. The most important thing is that you make an informed choice that is right for you.

Making the decision to skip breast reconstruction with tissue flaps or implants after mastectomy and go flat instead is a very valid choice. It is important to choose what best suits your preferences and lifestyle.

Learn more about Deciding to go flat.

Aesthetic lay-flat closure is considered the gold standard for lay-flats and delivers the best results. This procedure is sometimes also called post-mastectomy chest wall reconstruction.

Learn more about Aesthetic flat closure

Some surgeons favor breast reconstruction with tissue flaps or implants. If you’ve decided to go flat, it’s important to find a surgeon who listens and respects your choice.

Learn more about Talk to your surgical team about the flat lay.

People who choose to go flat after a mastectomy become much more visible. Lending their support are celebrities who are also going flat after mastectomy, including actors Kathy Bates and Anjelica Huston and comedian Tig Notaro.

Nonetheless, it’s up to you if you discuss your decision to go flat with your friends and loved ones. You might want to consider making a list that includes:

  • people you would like to talk to

  • how you would like to tell them – whether in person, over the phone or in a group chat

  • exactly what you feel comfortable sharing

  • limits so that they understand that you may not necessarily be willing to answer all of their questions

Sex after being flat

For many people, breasts are an important part of sexual arousal and intimacy. So it’s natural to wonder – or even worry – what sex might look like after a cosmetic flat closure mastectomy. It is important to know that sex after an aesthetic flat closure mastectomy can be just as fulfilling as it was before surgery.

Some people find it helpful to talk to a sexual health therapist who works with people with breast cancer.

A therapist or counselor can also offer advice on:

  • how to tell your sex partners about your decision to go flat

  • how to navigate the adjustment period after surgery to determine what you feel comfortable doing with a sexual partner

  • how to communicate your needs and desires to your sexual partners

You may also find it helpful to talk with others who have similar experiences. Organizations such as Breastless, Don’t put on a shirt, Flat closure NOWand Flat and fabulous can be valuable resources, as can online discussion forums such as Living Without Reconstruction After Mastectomy in our community.

Above all, remember to be patient with yourself. Sex and intimacy happen one step at a time after mastectomy.

Physical recovery from mastectomy without breast reconstruction is generally easier than physical recovery from mastectomy with breast reconstruction. People who have breast reconstruction with tissue flaps or implants usually need at least two procedures to achieve the desired results – or even more so that the breasts are evenly balanced (symmetrical). Going flat usually only requires one procedure, although sometimes more than one procedure is needed to achieve a flat closure.

Before you have the surgery, the surgeon explains the procedure to you and lets you know what to expect. For example, most women have numbness in the chest area after a mastectomy. Your surgeon should also give you postoperative instructions to follow once you leave the hospital. It’s always a good idea to ask if there are any activities you should avoid after surgery, such as heavy lifting or strenuous exercise involving your chest and upper body. You can also ask if a physiotherapy program makes sense for you.

Some women report feeling a sense of grief and loss after falling flat, at least initially. But others say they feel liberated because they no longer have a body part that threatens their health and well-being.

For some women, living flat or asymmetrically (having only one breast) seems natural, and they never or rarely use breast implants. Still, it can take some time to adjust to a flat chest and to figure out what makes you feel comfortable. For example, you may prefer to wear a breast form most or all of the time. The important thing is to take your time and go at your own pace.

Women who go flat sometimes choose to adorn their post-mastectomy breasts with tattoos – either decorative artwork that usually camouflages the scarred area, or restorative tattoos that resemble a nipple and breast. an areola. People who get decorative tattoos have to pay out of pocket, but some health insurance plans may offer partial coverage for nipple tattoos.

If you want something that looks and feels like a nipple, you might want to consider trying removable polyurethane or silicone nipples. These nipples have realistic textures and colors and often come with different levels of projection: mostly flat, semi-erect, or erect. To attach the nipples, moisten the back and stick them on – like a little suction cup – or use a temporary adhesive that helps them adhere to the skin. You can put them on and take them off as you see fit.

Some flat-going women are proud of their flat chest and prefer to dress in a way that accentuates flatness. Other women who go flat feel more comfortable dressing in a way that draws attention away from flatness. There is no right or wrong way to dress. You can try experimenting with different styles and you may even find that your preferences change after living in an apartment for a while. If you are looking for terms like go flat Where flattery on Instagram you can see all the different styles that women who live in apartments are wearing. If you prefer to wear clothes that camouflage a flat chest, you can find different styles of clothing on flat advocacy websites and online support groups for people who go flat.

Some women who choose to go flat decide to wear breast forms all the time or only in certain situations.

If you’re interested in going flat and wondering what you might look like after surgery, it might be helpful to look at pictures of women who have gone flat. In the United States, organizations like Breastless, Don’t put on a shirt, Flat closure NOWand Flat and fabulous provide information, tools and resources such as photo galleries, brochures and informational videos. On social media, there are many Instagram accounts and Facebook groups created by women who have chosen to be flat after a mastectomy. Sometimes people who decide to go flat call themselves flat campaigners, flat defenders, or flatterers.

Written by: Kristine Connercollaborating writer

– Last updated on August 2, 2022, 9:50 p.m.

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