2018 Archive

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What Flat Denial Is, and Is Not

December 16, 2018

We would like to clear up any confusion about what flat denial is, and what it is not. We want to directly address the conflation of minor cosmetic defects with the egregious results that constitute flat denial, as well as the conflation of women who were on the fence about reconstruction with those who made an affirmative choice to go flat.

Finally Flat: Stephanie’s Revision Story

December 15, 2018

After being told by a plastic surgeon that her result was not fixable, Stephanie found a team of general surgeons specializing in breast surgery who were willing and able to help her. She recently underwent the corrective “revision” surgery to repair her chest and create a truly flat contour. Now she shares with us a story of hope and perseverance.

NPoaS on the Breast Advocate App!

December 14, 2018

Not Putting on a Shirt is now included as a resource on the shared decision making* app, Breast Advocate, now available on iPhone and Android!


December 10, 2018

Dragon boating helped Sandee to find her voice after cancer.

Patient Advocate Sandee: “We all need advocates to help us speak our truths”

December 03, 2018

“We all need advocates to help us speak our truths when we feel broken into bits. It can be hard to demand our rights when we are afraid and it can be hard to stick to what we want when we feel bullied by what others want. Surgeons have no right to tell us what to do based on their definition of beauty.” – Sandee

“I am still feminine, with my new body.” – Rebecca

Rebecca’s Choice: Going Flat with Radical Self-Acceptance

December 01, 2018

“For me, the real power comes from saying ‘I am enough JUST like this’ and believing it, living it, sharing it. I dress in ways to highlight how flat I am, to show my scars, to show the whole thing sometimes. And every time I do, I feel it is a statement, not just for me, but for every woman I pass. We are okay JUST how we are.” – Rebecca

Note: Rebecca passed away on October 25, 2019. Her kindness and words of wisdom remain her legacy. Rest in Peace.

Maribeth: “Instantly I awakened to the reality of all that had happened”

November 27, 2018

Editor: Maribeth’s well-articulated experience below is an example of flat denial by intentional disregard – when a surgeon performs a skin-sparing mastectomy instead of the agreed-upon flat closure, in order to facilitate future recon “in case you change your mind.” Some surgeons lack the skill to make the patient flat, but that wasn’t the case here. Maribeth’s surgeon, in the year of #MeToo, simply decided she knew better than the patient – and there was nothing to stop her from following through with her plan. Who will protect these patients?

Guidelines for Victims of Flat Denial: Navigating the Aftermath

November 09, 2018

Not Putting on a Shirt has written new guidelines to help victims of flat denial navigate the aftermath of this traumatic experience.  The guidelines include:

  • Taking care of your emotional well-being
  • Ensuring that you receive proper medical care
  • Considering revision surgery
  • Finding a new surgeon
  • Steps you can take to get justice

How to Ensure You Get an Acceptable Surgical Result: Guidelines for Patients

November 08, 2018

Not Putting on a Shirt has created an informational brochure (UPDATED!) for patients who have chosen to go flat after mastectomy, to help patients protect themselves from flat denial. Every patient deserves to have the cosmetic result that they choose following mastectomy, and to have that done in one surgery whenever possible.

“Going flat doesn’t mean just breast removal… it means being flat and having a nice chest contour” – Dr. Minas Chrysopoulo

November 06, 2018

DiepCFoundation patient advocate Terri Coutee has written an insightful article from the perspective of a woman who chose reconstruction, and who advocates for educating patients about their reconstruction options. She read about flat denial in Catherine Guthrie’s Cosmopolitan article and was saddened by the victimization and trauma that the women featured were describing.

“It’s Your Body – Your Choice” Dr. Patricia Clark Speaks About Flat Closure

November 06, 2018

Dr. Patricia Clark, a breast surgeon who specializes in oncoplastic breast surgery techniques (lumpectomy as well as flat closure), has made a short video in support of patients who wish to go flat after mastectomy.

NPR Interview With Catherine Guthrie

November 02, 2018

Women’s health journalist Catherine Guthrie, whose groundbreaking article in Cosmopolitan blew the lid off of flat denial, was just featured on NPR talking about her own story and about the struggle that women face getting our wishes respected and our needs met.

“There’s… a long history of women being treated dismissively by the medical establishment… That this [flat denial] happens on a regular basis is an abomination, it’s a violation.” – Catherine Guthrie, speaking with NPR

Pink Lotus Breast Center: Flat Denial is “Unthinkable”

October 31, 2018

Wise words from the digital platform of esteemed breast surgeon, author of “Breasts: An Owner’s Manual,” founder of the Pink Lotus Breast Center and the Pink Lotus PowerUp Online Community, and special guest on the October 2nd Today Show segment on flat denial, Dr. Kristi Funk:

“According to Dr. Kristi Funk, breast cancer surgeon and author of the bestselling book, Breasts: The Owner’s Manual, it is unthinkable that a surgeon overrules a patient’s clear directives arrived at after careful consideration…” – Pink Lotus

Word Continues to Spread through the Surgical Community

October 31, 2018

Not Putting on a Shirt founder Kim Bowles was featured in a University of Colorado oncoplastic surgery presentation on September 24th (just published mid-October). Oncoplastic surgery is cancer surgery using specialized techniques to improve the cosmetic result. Watch on YouTube here (Kim is at minute 6:19).

Walk Day is TOMORROW!

October 22, 2018

Join Not Putting on a Shirt to show your support for the cause – to put an end to flat denial and ensure that women receive cosmetic results we can live with following mastectomy.

There are two ways to participate: in person, or online with the hashtag #notputtingonashirt

Sindee – She has to wait years for revision

October 22, 2019

After age 60, close to four out of five women forgo reconstruction. Oftentimes, as with Sindee’s case, it’s because the risks of additional surgeries outweigh any cosmetic benefit, due to slower healing simply because of the woman’s age (Sindee was 60yo), and/or co-existing health conditions that affect surgical risk such as diabetes (as with Sindee) or heart conditions, which are more common in older women.

Stephanie – “The last thing I said to him on my way to surgery was, ‘I trust you’”

October 04, 2018

The paternalism and sheer audacity are shocking. But this is what happens when surgeons are not held accountable – and it will continue to happen, until, as Stephanie says, we expose this cruel, abusive practice for what it is: medical assault and battery.

NPoaS on the Today Show!

October 02, 2018

Women’s health journalist and author of “FLAT: Reclaiming my body from breast cancer” Catherine Guthrie and Not Putting on a Shirt founder Kim Bowles were just featured on the Today Show this morning, talking to co-host Stephanie Gosk about paternalism and malpractice against mastectomy patients.

Register now for the NPoaS Walk on Oct 23rd!

October 01, 2018

How did we choose Oct 23rd? Much like with an awful mastectomy result, someone else chose it for us… Cleveland Clinic is holding their own event, an annual “Innovation Summit,” from Oct 22-24th. It’s a good opportunity to make sure that we, the patients, are seen and heard by the people who hold the power in the medical community.

Wanda – “This should be the norm!”

September 29, 2018

Editor: Wanda got a great flat result and was “one and done” (the initial flat closure was satisfactory). Many women who choose to go flat, plan to get a tattoo across the mastectomy site (the canvas, so to speak) after healing from surgery – it’s a way to reclaim ownership of one’s body, and to heal emotionally through artistic expression. For women who are victims of flat denial, our plans are crushed when we wake up to a ruined canvas. Wanda lucked out with a skilled, ethical surgeon, and she got the result that every woman deserves – the result that she chose. It shouldn’t be a matter of luck.

International Media Coverage Begins

September 29, 2018

International media coverage is starting to trickle in… in the same way that we at Not Putting on a Shirt hope that the still small voice of their conscience is now starting to trickle into the minds and hearts of the surgeons who are responsible for inflicting flat denial upon unwitting women.

Brut Media Publishes Not Putting on a Shirt Video

September 29, 2018

Digital platform Brut America, which publishes short news/issue videos on social media to engage viewers, has picked up on NPoaS’ patient rights activism and just published a great Facebook video about it… thanks to Brut for helping get the word out!

Harvard Medical School Social Work Program Manager Emeritus Speaks Out on Patient Consent (Article)

September 29, 2018

I really took heart when I read Hester’s article because so far, we haven’t heard from many medical professionals who are willing to address flat denial publicly. The medical community at large is finally taking notice! This is clearly due in large part to recent media and social media coverage of the issue, and at its core, is the product of so many individual women pouring their hearts and souls into this work.

September 28, 2018

Women’s health journalist Catherine Guthrie‘s Cosmopolitan article last month dragged the despicable practice of flat denial out of the shadows and into the light of day. Guthrie recently posted on her blog that she was contacted by one of the surgeons she had interviewed during the course of her (extensive) research, and what she heard from this surgeon blew me away.

Lisa – “Nothing could have prepared me for what I looked like after surgery”

September 26, 2018

Editor: Lisa had OVER A DECADE to decide what surgical option she would choose if her original breast cancer returned. Still, her surgeon unilaterally decided to leave her with a skin-sparing mastectomy to facilitate future reconstruction. Lisa says in her story that she should have consulted a plastic surgeon… but, as we know from my own story (Kim) and others, bringing a plastic surgeon onto the team does NOT guarantee a decent flat result.

PSA: Now available – list of “flat-friendly” surgeons

September 21, 2018

Great news for women who are facing mastectomy and wish to go flat! We at Not Putting on a Shirt have been entrusted with a carefully compiled list of “flat-friendly” surgeons across the US and beyond, who were recommended by women who have gone through mastectomy and have been satisfied with their flat results.

Note: the list is now available as a searchable online Directory!

ATTN: Greater Cleveland Area Women!

September 20, 2018

Please, consider sharing your story! This will help spread awareness of medical assault and battery against mastectomy patients. It’s easy to ignore one woman speaking out… not so easy when we all stand together and take courage from each other’s stories.

Save the Date! Tuesday, October 23, 2018 – Cleveland, OH

September 20, 2018

Why October 23rd? Well, Cleveland Clinic, the #2 hospital in the nation, who has actively and repeatedly covered up the malpractice perpetrated against me in 2017 by their surgeon Dr. Steven Bernard, will be holding their 2018 “Medical Innovation Summit” from October 22-24.

Brenda – “I should not have to feel embarrassed or humiliated by my own body, ever.”

September 19, 2018

Editor: Brenda’s story really shows what an impact we can have when we go public with our stories. Breast cancer treatment is an extremely isolating experience. But now that we have flat advocates like Melanie Testa, Beth Fairchild, and others – now going flat is beginning to be normalized. People are starting to realize that it’s ok not to reconstruct. And that as patients, we have the right to expect high-quality surgical care and a reasonably flat result.

“Deborah” – Flat Women Before Me Paved the Way

September 18, 2018

Editor: “Deborah” asked that her story be shared anonymously. She was lucky to have a surgeon who respected her wishes to go flat, without her having to take extraordinary measures to protect herself. This experience of respect by default – this is what ALL mastectomy patients deserve.

Call to Stakeholders to Speak Out Against Medical Assault

September 18, 2018

The difference between torture and lifesaving cancer treatment, is consent. We cannot allow this gross violation of woman’s bodily autonomy to continue unacknowledged and unchecked.

September 18, 2018

A skin sparing mastectomy and a mastectomy with complete removal/flat closure, are two different procedures. If a patient consents to one procedure, and then while they are unconscious the surgeon decides to perform a different procedure, that action is unethical and a violation of the patient’s consent. It is also illegal, and constitutes battery.

$$$ Conflict of Interest for Flat Closure $$$

September 18, 2018

Payment is not the only factor at play here. But it’s clear from the reimbursement perspective that plastic surgeons are highly disincentivized to provide a flat result in one surgery.

I’m sharing this image with permission from the woman pictured. You can follow her on Twitter @clreid56

Shouldn’t CANCER be your toughest fight when you’re fighting breast cancer?

September 18, 2018

The only real matter of choice in the whole nightmare is the reconstruction decision. It’s the only component of breast cancer treatment where the patient’s feelings, opinions, AGENCY, affect the actual experience. To snatch this away is the height of cruelty. It’s dehumanizing. It’s unethical. It’s wrong.

The Hippocratic Oath

September 18, 2018

The modern Hippocratic Oath serves as a moral code governing the actions of today’s physicians. As a patient whose consent has been violated by the surgeon I entrusted with my body and my life… I would love to know what transpires in the minds of surgeons who cross the line and decide that they can and will commit this violation. Because if I knew, I might be able to stop it.

What You Can Do to Protect Yourself

September 18, 2018

I am often asked, by a woman facing mastectomy and wanting a flat result, what steps can she take to protect herself from being left mutilated as so many women have been?

Note: access the Protect Your Choice brochure here.

The Future of Not Putting on a Shirt

September 18, 2018

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…

“Flat Denial”: Stand Up, Speak Out, and Protect Patients

September 16, 2018

I have struggled to come up with a label for the malpractice of leaving extra tissue on a mastectomy patient’s chest against her consent. Labels matter – it’s hard to speak about an experience if you don’t have verbiage to describe it.

Dawn – “No other options were given to me”

September 15, 2018

Is it not enough to have terminal cancer (which 1/3 of early stagers WILL DIE FROM) but then to have your medical team, who you trust with your body and your life, treat you as though you just don’t matter. The trauma this causes to a person is immeasurable. And totally avoidable – good surgeons MUST stand up and speak out against this type of mistreatment, if it’s to end. Thank you, Dawn, for sharing your story.

Cindy – Her surgeon joked about overriding her wishes to be flat

September 15, 2018

Editor’s note: Please note the egregious and blatant disrespect of the patient’s wishes here. This surgeon felt so comfortable overriding this woman’s consent, that she actually openly joked about it in the post-op consult. This is unprofessional, predatory, abusive behavior. Luckily, in this case, the woman was able to get a revision to fix what the original surgeon did to her.

Cassandra “My surgeon was a woman…”

September 14, 2018

I ended up with extra skin, or dog ears, “in case you change your mind.” It was bad enough I was losing my breasts, but to have this ugly, bumpy chest afterwards was not okay with me… I don’t like seeing my chest. I still have some pain in some areas. I do not want more surgery.

Suzie – “Deflated” after explant

September 14, 2018

After explant, there will almost always be significant excess skin remaining, and if the surgeon does not remove it, the patient is left looking “deflated” which for most women is an absolutely unacceptable result. Removing the excess skin takes time and skill. Women who choose to explant are no less deserving of a decent flat result, than women who choose flat from the beginning.

Not Putting on a Shirt Central

September 10, 2018

Following are links to all NPoaS resources and media coverage that give the background of what we’re about, how to connect with us on social media, share your story, and support the work of Not Putting on a Shirt.

Walk Day is a Week Away

September 02, 2018

Your participation sends a message. Women are capable of deciding whether to go through the breast reconstruction process or not. A flat cosmetic result is good outcome following mastectomy, for women who choose it…

We are committed to changing the system that allows surgeons to disregard patients’ wishes.

Flat and very pleased with the results- A Previvor’s Story

August 15, 2018

For what it’s worth, I wore a 36G bra before mastectomy, so the excuse that a surgeon can’t make a woman flat due to their chest size doesn’t hold water. It isn’t wise to expect a “perfect” post-mastectomy result (medicine is an imperfect science, and closing a round opening with a linear seam is tricky), but we should be able to expect acceptable results.

I had a surgeon that cared- Lonnie’s Survivor Story

August 14, 2018

I was one of the lucky ones…I had a surgeon that cared about the cosmetic results. My chest is flat and my scar barely visible. She was a breast cancer surgeon…that’s all she does… As a surgical student she spent extra time learning how to close an incision and give her patient the best possible outcome.

She asked to be flat- Shelly’s Survivor Story

August 13, 2018

I have cried off and on since dressing came off. It comes and goes. I feel grossed out when I look at it and disgusted. I guess what I am feeling feels like grief. I am sure it will pass eventually and I will be very mad.

$5 Off Registration and T-Shirt Orders– Three Days Only

August 07, 2018

Show your support by sharing a photo of you wearing a Not Putting on a Shirt tee, on Facebook or Twitter, on our walk day, Saturday, September 8, 2018.

Why She’s Not Putting on a Shirt, and Why We’re Walking With Her

July 28, 2018

This is the story of how Kim Bowles, an introverted, but bold, scientist and mother of two toddlers, ended up protesting topless on a sidewalk in Cleveland. This is why you should walk with us on September 8, 2018. (Author: Amanda Newill)

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This site contains copyrighted material. Not Putting on a Shirt’s educational materials and resources on this site are freely available for “fair use” (Title 17 U.S.C. Section 107) in accordance with our mission to advocate for optimal outcomes for those who choose to go flat after mastectomy.  The copyrighted material on this site is distributed for educational purposes without profit – all donations to Not Putting on a Shirt directly fund our advocacy work. If you wish to use copyrighted material from this site for purposes that go beyond “fair use”, you must first obtain explicit permission from the copyright owner. Please direct requests or questions to info@notputtingonashirt.org.