The Future of Not Putting on a Shirt

the future of NPOAS

PicsArt_09-18-12.05.39CREDIT: Amanda Newill

After I watched Kim Bowles whip of her shirt at the CEO’s office at Cleveland Clinic and demand to be heard, I knew I could support her in her cause.  Together, we founded Not Putting on a Shirt to advocate for satisfactory cosmetic outcomes—as agreed upon by mastectomy patient and surgeon(s)—for those who choose to “go flat.” – Amanda Newill, co-founder of Not Putting on a Shirt

Since her original sit-in, Kim has protested topless at Cleveland Clinic several times – sometimes alone and sometimes with the support of friends and family. She has been interviewed and featured in local TV news and national electronic print media. Not Putting on a Shirt is gathering a large following in social media. We have created an informational brochure, and our website is in the works.  We have hosted a growing database of “flat-friendly” surgeons for women facing mastectomy to have in their arsenal.  Additionally, we have created our “Going Flat After Mastectomy” survey, to provide us with some data to help us understand and address the problem of surgeons acting against patients’ wishes. Our t-shirt sales have helped generate funds to cover operating expenses.

What’s Next for Not Putting on a Shirt?

Continuing Our Ongoing Work

We will continue with the efforts we have already begun. Our “Going Flat After Mastectomy” Survey will be open through June of 2019, after which time, we will write a report on the data we have collected.

Kim will continue to protest in Cleveland when she can.  In October of this year (2018), we may be staging a protest at the Cleveland Clinic 2018 Medical Innovation Summit  (ironically, they call it “Disruption: Reimagining Healthcare,” and their stated goal is to “cut through the noise to ultimately deliver results to those who need it most: our patients.”).  Then in June 2019, we plan to start an annual nationwide awareness walk.  The walk on September 8th served as a good model for future walks despite the modest turnout.

Our social media interactions will provide community and support for women who have had mastectomies and women who will have mastectomies.

T-shirt sales will continue, at least until we have sold most of the shirts. In spring, we will probably sell women’s tank tops in time for the annual walk.

We will begin to work in earnest on our legislative agenda.  The goal is to have going flat as a legitimate reconstruction option (“flat reconstruction”), written into the WHCRA (Women’s Health and Cancer Rights Act of 1998), the federal law that requires insurance companies to cover breast reconstruction.  Right now, insurance companies are left to interpret the WHCRA and many interpret it to include breast mound reconstruction but exclude flat reconstruction. Credit: Melanie Testa

Providing Informational Support

Our website will include articles and links to research regarding a large number of topics related to reconstruction after mastectomy. Given plastic surgeons provide ample information about breast reconstruction, we will focus mainly on flat reconstruction, including considerations women make when choosing to go flat, surgeons with proven track records in providing acceptable flat results, going flat after explant, and more.

We are considering creating a booklet that can be sent to oncologists and directly to patients, near the time of diagnosis, that will discuss the option of not reconstructing breasts.

Additionally, we will review existing publications about mastectomy, breast cancer, and going flat, and share these reviews with our supporters.

Outreach and Networking

We’ll be seeking opportunities for Kim to speak women’s groups, starting locally. Additionally, we’ll start efforts to connect with surgeons who are “flat friendly,” as well as beginning a campaign in 2019 to attempt to inform surgeons about the flat option and encourage them to embrace this option.


The 2019 awareness walk and tank top sales will be our main fundraiser.  Our first capital campaign will begin shortly, where our goal will be to raise $10,000 to support Not Putting on a Shirt’s operating expenses. Funds will be used for:

  • Website design, hosting, and upkeep
  • Social media management, including publishing stories of those who have been through mastectomy/ies
  • Steps toward becoming a 501(c)(3)
  • Creating a supporter database and mailing list
  • Recruiting and organizing volunteers
  • Nominating and vetting potential board members
  • Possibly start looking for grant opportunities

By the end of the year, we hope to set a timeline for establishing a nonprofit corporation, obtaining a federal EIN, building a board of directors, etc. A strategic planning meeting will take place in January 2019; one focus at that time will be creating an operating budget and fundraising strategies.

Donations in support of our work may be made in the following ways:

  • PayPal to
  • Send check or money order payable to Kimberly Bowles to Not Putting on a Shirt, PO Box 111215, Pittsburgh, PA 15238

Published by Not Putting on a Shirt

Founder of Not Putting on a Shirt, a mastectomy patients' rights organization that advocates for optimal surgical outcomes for patients going flat.

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