Flatties Unite: The Choice to Forego Breast Reconstruction

Flat as a pancake. Yep, that was me, right after surgery to remove breast cancer. I was different, but I didn’t realize how different how I felt until months later.

A week or two after I’d received my diagnosis of breast cancer, I met with a surgeon to discuss my case. She assumed I wanted breast reconstruction after a double mastectomy to remove cancer—she was wrong. I didn’t want to restore what cancer had taken from me. I told her in no uncertain terms, I wanted to be flat.

“Are you sure?” she asked. “I can leave extra skin so we can insert expanders until you’ve healed enough for implants or; we can move fat and tissue from other areas of your body to sculpt new breasts.” It seemed she wouldn’t take no for an answer. Several more times the surgeon tried to persuade me to opt for reconstruction. She even argued it would make my marriage better. At each insistence, I replied, “No.” I explained if breast cancer was going to take my breasts, I didn’t want any residual evidence of their existence. I would be flat and that was that.

The procedure I’d chosen was called an aesthetic flat closure, one where all extra skin, fat and breast tissue are removed. The doctor explained, after the process was complete, everything else would be tightened and smoothed to provide a completely flat chest wall. She assured me she’d do her best to make sure I didn’t end up with dog ears. “Dog ears?” I questioned. She explained sometimes, when performing an aesthetic flat closure, a patient could end up with extra skin just behind the armpits. Those were called dog ears because of their triangular shape. I definitely didn’t want those.

After the surgery was complete and healing had taken place, I felt very alone. I knew there were other double mastectomy patients, but how many of them had chosen to forego reconstruction? I assumed not many. The majority of women opted for one form of reconstruction or another, or they’d chose implants. Being flat wasn’t popular—so I thought.

One day, while perusing social media, I happened across a group called “Flatties Unite.” As I scrolled through the feed, I was surprised to find others like me who’d chosen not to reconstruct. Quickly, I joined the group agreeing to abide by the rules and accept the privacy conditions. I also agreed not to be offended by topless photos that may appear in the feed. 

As I read through posts, I was overwhelmed by the openness and honesty of the members. They were unashamed of their scars. They had grown to love and accept themselves. They were proud to be alive. Finally! I’d found ladies who understood the ins and outs of living life flat. What a comfort to know I was not alone in my choice.

The “Flatties Unite” group has been a perfect fit. They’ve been understanding and kind. It’s a unique sisterhood. The shared photos have been raw and real. They’ve included ones taken immediately after surgery and others reflecting daily life. There have even been random photo challenges like “Flatties in the Wild.” Each challenge provides fun and encourages members to participate.

The group members find ways of normalizing tragedy and that’s what speaks to me most. Most people understand breast cancer produces physical scarring, but many don’t understand the emotional effect it can inflict upon one’s wellbeing. “Flatties Unite” and other support groups can help a person develop coping skills.

We were built for community. With the social distancing guidelines currently in place, it’s often challenging to gather with others, but virtual tribes provide meetings all hours of the day and night. If you’re not sure where to find others like you, try an internet search for breast cancer survivors, or use the search bar on any social media platform.

Flatties aren’t freaks. We’re women who’ve chosen to forego extra surgeries and live our lives to the fullest, without cumbersome fake breasts. Choosing to live life flat is a very personal decision and one that must be carefully considered. It is not for everyone. Many doctors discourage women from going this route, but you do have the option should you so choose.