2020 Archive

Looking for a particular NPOAS blog post? Browse our archives. Posts are listed below in chronological order with the newest posts at the top.

Conference Update

May 03, 2020

As the world grapples with the COVID-19 pandemic, NPOAS remains focused on protecting the interests of women going flat after mastectomy. We recently saw an important stakeholder, the OPBC, take the historic step of including optimal flat closure in their mission statement. Stakeholder outreach will continue to be a strong focus as we proceed through this year.

The 2020 Annual Meeting of the American Society of Breast Surgeons in Las Vegas, which we had planned on attending as exhibitors, was recently cancelled due to the pandemic. Therefore, we look forward to attending the 2021 Meeting in Orlando, Florida, next Spring. All donations from the #ASBRS2020 campaign will be rolled over to fund our attendance at the 2021 Meeting.

Pioneers in Flat Advocacy: Charise Isis (The Grace Project)

April 24, 2020

Charise Isis is the photographer, founder and executive director of The Grace Project, an ongoing series of portraits that capture the courage, beauty and grace of those who have had mastectomy surgery as a result of breast cancer. Charise’s work helps not only those she photographs but the audience who can identify with those figures and hopefully come to see their own beauty when they look in the mirror and see themselves radically changed. The Grace Project has been widely exhibited both nationally and internationally, including features on the Today ShowBust MagazineMedical Daily, and more, and recently achieved 501(c)(3) status as a registered nonprofit.


OPBC Adds “Optimal Flat Closure” to Mission

April 19, 2020

A Step Towards Parity

The Oncoplastic Breast Consortium (OPBC) is an independent, international nonprofit organization led by a coalition of world-class surgeons working to bring safe and effective oncoplastic breast surgery to routine patient care. OPBC aims to continuously improve oncoplastic breast surgery by bringing international experts together, promoting high-quality education and performing international multicenter studies.

We are thrilled to report that OPBC has just added “optimal flat closure” to their mission statement, recognizing flat closure as an oncoplastic procedure deserving of an aesthetic surgical approach alongside breast preservation and reconstruction. This is an important step forward towards parity for flat closure.

Pioneers in Flat Advocacy: April Stearns (Wildfire Magazine)

April 17, 2020

April Stearns was diagnosed with Stage III breast cancer when she was 35 and her daughter was 3. Prior to breast cancer she worked as a conference producer with a background in journalism. She started a personal blog after her daughter was born and continued writing through diagnosis and treatment. That blog grew into Wildfire Magazine, the only magazine exclusively for young breast cancer survivors and thrivers. Each of the six annual issues focuses on survivorship issues faced by women diagnosed with breast cancer in their 20s, 30s, and 40s – self-care, mental health, body image, (in)fertility, and more. April’s work is guided by the principle that sharing our stories helps us all heal and not feel so alone.

Pioneers in Flat Advocacy: Stephanie Astalos-Jones (FLAT Is Where It’s At)

April 10, 2020

Stephanie Astalos-Jones is an actor, writer, stand-up comic, teacher, pysanky (traditional Ukranian batik egg decoration) artist, and saw-player from Georgia who chose to go flat after her mastectomy in 2018. Unfortunately, her surgeon left her with an egregiously poor surgical result “in case you change your mind” (his words at her post-op follow up), and she then had to fight to get her revision surgery after the first plastic surgeon she consulted told her that “women can’t be flat.” In 2019, Stephanie started FLAT Is Where It’s At, a podcast for and about flatties where she and her guests discuss the specific problems, weird situations, and wonderful freedoms that we experience living the flat life.

Pioneers in Flat Advocacy: Chiara D’Agostino

April 03, 2020

Chiara D’Agostino is a former ESL teacher and dancer, now a prolific model and flat advocate, as well as a vocal advocate for metastatic breast cancer research. Chiara was diagnosed stage III in 2014, and progressed to stage IV shortly after. She originally chose to reconstruct her breasts with implants but explanted after persistent, repeated infections that were affecting her health and quality of life. Chiara modeled for the 2017 AnaOno  +  #Cancerland NYFW fashion show benefiting Metavivor, and has been featured in numerous publications over the last six years: Oprah MagazineDove’s Real Beauty campaignCancer TodayHealth.com, the You Run Like a Girl project, and on the LBBC blog, to name just a few.

“In Search of True Informed Consent” (Wildfire Magazine)

March 31, 2020

Christy Avila is a career educator, mother, and explant and flat closure advocate. She founded the support group Fierce, Flat, Forward, and co-founded International FLAT Day. She has served as the Vice President of NPOAS since November 2019.

Christy tells us more about her article “In Search of True Informed Consent” that was published in the most recent issue of Wildfire Magazine.

Empowering Patients with a Bill of Rights

March 29, 2020

A coalition of leading oncologists and researchers recently published their own proposal for a Cancer Patient’s Bill of Rights… Of particular interest to patients facing mastectomy and considering their reconstructive options is the proposal’s principle of equitable treatment – including “the right to balanced information about treatment options, provided in understandable language, that takes into account their priorities and values.” These three components – balanced information, clear language, and shared decision making – are critical to achieving parity for flat closure.

Pioneers in Flat Advocacy: Beth Fairchild

March 27, 2020

Beth Fairchild is a mother, tattoo artist, and strong advocate for both reconstructive choice and metastatic breast cancer (MBC). She has been living with MBC since her de novo diagnosis in 2014. Beth initially decided to go flat after her mastectomy to protect her treatment timeline and options. After three years with stable disease, she decided to pursue implant reconstruction.

Beth served as the President of Metavivor for three years, continuing to serve on the Board today. She is the creator and producer of Metavivor’s  #ThisIsMBC initiative, and is also a Director of #Cancerland. Beth was the first MBC patient to be featured in Glamour, and has also been featured in Oprah Magazine, the Today ShowA Story Half Told, Third Love’s #TheUnderneathProject, and more.

Pioneers in Flat Advocacy: Barbara Kriss

March 20, 2020

When Barbara Kriss needed a bilateral mastectomy in 2006, she realized that she didn’t want reconstruction but couldn’t find information or support for women who felt like she did. In 2007, she founded BreastFree.org, a non-profit website that presents non-reconstruction as a positive alternative to reconstruction. BreastFree.org has information about living breast-free with and without prosthetics, as well as a flat closure image gallery and stories from women who chose to go flat. Barbara has been featured in the Chicago TribuneCure MagazinePaint it All Pink Magazine, and BreastCancer.org.

#ASBRS2020 Will Be Postponed Due to the COVID-19 Pandemic

March 16, 2020

Late yesterday, the CDC issued new recommendations (no mass gatherings for eight weeks) that indicate that #ASBRS2020, originally scheduled for April 28th – May 3rd, will be postponed. Shortly afterwards, the corporate venue (MGM) took the initiative to close down their facility. Our many thanks to the CDC, other agencies, and MGM for their leadership in taking the right steps to protect the public health.

We will be pausing our conference fundraising efforts until we have more information, but our work to protect the interests of women going flat will continue unabated. Thank you for your support, and stay safe out there.

Pioneers in Flat Advocacy: Ms. Rosewater

March 13, 2020

Ms. Rosewater (Regina Matthews) is a musician, visual artist, dancer and model with a powerful presence and voice. She had a double mastectomy in 2019 and chose to go flat to protect her health and well-being. She started sharing her experience on social media as affirmation and to take ownership of the struggle. Ms. Rosewater has modeled for Ana Ono + #Cancerland‘s 2020 NYFW show benefiting Metavivor. She holds an annual not-for-profit event with live music, art, food, yoga and more in Los Angeles, California – the “Fuck Cancer Kickback + Jam.” You can find Ms. Rosewater’s work on YoutubeFacebookInstagram and online at ThisIsMsRosewater.com.

Demand Parity for Flat Closure – Amend the NAPBC’s Reconstructive Consult Protocol

March 15, 2020

The vast majority of mastectomy closures are performed by surgical oncologists, who may or may not have any training in plastic surgery techniques. This is certainly a contributing factor to the 25% dissatisfaction rate for women going flat. Therefore, until oncoplastic training becomes standard for surgical oncologists, women should be able to access a plastics specialist for their initial surgical closure to ensure they get the best possible aesthetic outcome.

… Flat advocates want a culture shift. To accomplish that, we must break down the institutional barriers that reinforce the status quo.

New Explant Brochure

March 09, 2020

Those who are facing explant post-mastectomy are particularly in need of solid, concise and comprehensive information that they can use during their consult to ensure their decision is respected. That’s because these women are really looking at two procedures: explant AND flat closure, neither of which have a robust standard of care in place that aligns with patient’s expectations.

Our new brochure “Going Flat After Implant Reconstruction: Your Body, Your Decision” was created to address this problem. It was produced by a collaboration of multiple stakeholders including explant activists, explant and flat closure specializing surgeons, and others. Much of the information on explant was sourced from Nicole Daruda’s HealingBreastImplantIllness.org, and the information on flat closure was sourced from other NPOAS publications. 

Pioneers in Flat Advocacy: Jersi Baker

March 06, 2020

Angela “Jersi” Baker of North Carolina was just 32 years old at her original diagnosis (stage 0). She had a single mastectomy with implant reconstruction. Eight years later she progressed to stage IV. Jersi founded her nonprofit, Angel In Disguise Inc., in 2015, to provide transportation assistance and support for local residents in who are undergoing cancer treatment.

Jersi is active with several organizations that advocate, promote awareness, and provide support for women of color facing breast cancer, including TigerLily FoundationSISTA Survivor, and BreastofUs. In 2016, Jersi decided to explant and go flat. She has modeled for the AnaOno and #Cancerland in their annual fashion show benefiting Metavivor.

Pioneers in Flat Advocacy: Juliet Fitzpatrick

February 28, 2020

Juliet Fitzpatrick of the U.K. became an advocate after struggling to have her own surgical choice respected in 2017. She was never offered flat as an option, and was initially denied a prophylactic contralateral mastectomy (to remove the healthy breast). She has a blog about life after cancer, Blooming Cancer, and her visibility work has been widely featured both publicly in the U.K. and online.

Support NPOAS at #ASBrS2020

February 27, 2020

A First in Flat Closure Advocacy

History is going to be made at the American Society of Breast Surgeons annual conference this Spring, and NPOAS is going to be there to see – and to make – it happen! For the first time, flat closure will be a topic of focus at a professional conference from the perspectives of both providers AND patients.

The NPOAS Board will be attending this #ASBrS2020 with an exhibitor’s booth to advocate for flat closure.

Vermont Insurer Blue Cross Blue Shield Supports Revision Bill

February 26, 2020

Big progress continues in Vermont in ensuring insurance coverage for flat closure and revision services! Representative Charen Fegard’s flat revision coding bill (Bill H.686) now has strong support from the state’s largest health insurer, Vermont’s BCBS.

Many thanks to Vermont BCBS for their support to protect the rights of a historically under-served patient population!

State of Vermont Moves to Protect Patients

February 23, 2020

Big progress is happening right now in Vermont to ensure insurance coverage for flat closure and revision services. Thanks to the pioneering bipartisan work of Vermont State Representatives Charen Fegard (D-VT) and Lynn Bachelor (R-VT), the Vermont state agency tasked with investigating insurance denials has just issued a Consumer Alert to gather information that will help make the case for the the passage of Bill H.686. This historic bill requires stakeholders to convene and produce a standard coding protocol for flat revision surgery.

Guest Blog: Plastics Closure Should Be Routine

February 23, 2020

Marie-Claude Belzile of Tout aussi femme is the leading voice for flat advocacy in Quebec. She recently published her book Penser le Sein Feministe (Considering the Feminist Breast) which deconstructs the cultural narrative about going flat.

The Importance of Having a Plastic Surgeon at the Initial Mastectomy for Women Who Choose Flat Closure.

There should be no ”poor” results, ever. They are entirely avoidable with routine plastics closure… Flat closure is – especially compared to traditional reconstruction – a fairly straightforward procedure that should be done in a couple of hours with perhaps an hour of extra operating time devoted to achieving proper aesthetics.

Guest Blog: At the Intersection of My Flat Chest and an Antiquated System of Care

January 26, 2020

Melissa Eppard is a certified Life Coach, writer, and breast cancer thriver. Today she’s speaking with us about women’s health, women’s autonomy, explant, and flat closure.

Women everywhere are calling for the standard of surgical breast cancer options to shift and include flat closure. We’re finally positioned culturally and historically to demand autonomy over our health care choices, and how we express our ideas of what is truly healthy and beautiful for ourselves.

Pioneers in Flat Advocacy: Trine Amazon

February 20, 2020

Trine Amazon of Denmark began blogging about her breast cancer experience shortly after her diagnosis in 2017. She examines beauty standards and gender norms from her perspective as a “magical uniboober and queer ninja,” and works to promote flat visibility.

Trine has worked closely with the hospital system in Denmark to ensure providers are offering the flat option to their patients, and one hospital even now offers flat closure pictures alongside their breast reconstruction gallery. You can find Trine’s work at TrineAmazon.com.

Pioneers in Flat Advocacy: Sara Bartosiewicz-Hamilton

February 14, 2020

Together with her late friend Barbie Ritzco, Sara Bartosiewicz-Hamilton founded Flat & Fabulous, a nonprofit organization committed to empowering, advocating and providing support for those who are living post-mastectomy without reconstruction. When Sara and Barbie first started their Flat & Fabulous Facebook support group in 2014, they had no idea how quickly it would take off. As of January 2020, the group has over 8,500 members and is still growing.

Informed Consent is Non-Negotiable

February 22, 2020

Australian Woman Says Her Surgeon Placed Expanders Without Her Consent

We know that about one in twenty women who choose to go flat are intentionally denied a flat closure by a surgeon who believes they will “change their mind” about implants. But leaving a patient with excess skin to facilitate future reconstruction isn’t the only egregious violation of consent that mastectomy patients face. Today we are sharing the story – and the online petition for justice – of an Australian woman, “Jane” (not her real name), whose surgeon placed tissue expanders during her mastectomy without her consent.

Pioneers in Flat Advocacy: Marie-Claude Belzile

February 07, 2020

Introducing Pioneers in Flat Advocacy: a blog series designed to highlight and amplify the voices of the flat advocates who blazed the trail and laid the foundation for others who followed.

Marie-Claude Belzile of Quebec, Canada began her advocacy work in 2017 after being diagnosed with stage IV breast cancer, undergoing a double mastectomy, and noticing that medical professionals and the public at large seemed uncomfortable with her new body.

You can find her work on her Facebook page Tout aussi femme. Marie-Claude recently published a book in which she deconstructs the cultural narrative about breast reconstruction, Penser le Sein Feministe. She also founded a French-speaking flat support group called Les Platines.

Clear Language: “Flat Closure”

February 02, 2020

Flat closure is shorthand for surgery to reconstruct the chest wall contour post-mastectomy. It is a patient-friendly term that serves as a stand-in for the more cumbersome technical description. The mastectomy first removes the glandular tissue of the breast, and the subsequent closure involves surgical contouring of any remaining excess fat and skin to reconstruct a smooth, flat chest wall contour. Hence, flat closure.

NPOAS’ Table at the 2019 AHN SABCS Review

January 24, 2020

Thanks to Allegheny Health Network and San Antonio Breast Cancer Symposium for putting together the 2019 AHN SABCS Review, and for providing for participation from local nonprofits. Kim was there representing NPOAS and spoke to quite a few medical professionals about flat closure, flat denial, our research and our initiatives. We got some hot tips on strategy. And we handed out dozens of International Flat Day’s “Flat is Beautiful” brochures!

Next year we will be targeting Review sessions across the country to continue to engage providers on this important topic. Stay tuned!

Flat Denial: Who is Most at Risk?

January 28, 2020

The Takeaway:

  • Choose a breast surgeon whenever possible rather than a general surgeon. Flat denial rates are tripled for general surgeons.
  • If you have a higher BMI and/or are older than 55, be especially vigilant.
  • If you sense pushback, find a new surgeon.

Kim’s Revision Surgery After Intentional Flat Denial

January 14, 2020

I shouldn’t be here, being prepped for revision surgery. I had a plastic surgeon at my mastectomy two years ago solely to do a flat closure. I had pictures, a witness, “smooth flat result” was in my medical record. My choice was to be done in one surgery. It was my choice. And it was stolen from me.

“I’ll leave a little extra in case you change your mind” is an attitude that forces women already traumatized by breast cancer treatment into yet another risky, costly, and anxiety provoking surgery in order to get a surgical result they can live with.

NPOAS’ Table at the 2019 AHN SABCS Review

January 24, 2020

Thanks to Allegheny Health Network and San Antonio Breast Cancer Symposium for putting together the 2019 AHN SABCS Review, and for providing for participation from local nonprofits. Kim was there representing NPOAS and spoke to quite a few medical professionals about flat closure, flat denial, our research and our initiatives. We got some hot tips on strategy. And we handed out dozens of International Flat Day’s “Flat is Beautiful” brochures!

Next year we will be targeting Review sessions across the country to continue to engage providers on this important topic. Stay tuned!

NPOAS Board of Directors

January 31, 2020

The new year brings a new crew and we are proud to introduce our new Board of Directors.

The expertise, knowledge, and diversity of experiences and talents of our Board of Directors are complemented by that of our growing professional Advisory Council. We are confident and enthusiastic about all that awaits in this new year and beyond, as we continue the important work of protecting the interests of women going flat.

NPOAS Exhibit at 2019 Pittsburgh SABCS Review

January 22, 2020

This important annual event provides for medical professionals who could not attend the San Antonio conference to learn about the cutting edge research presented there and to discuss the implications for clinical practice with their colleagues.

Engaging local providers and educating them about flat closure as a valid option, is critical to our mission to #putflatonthemenu. We will be showcasing our original research, distributing publications, and answering provider’s questions about flat closure.

Share Your Experience: Revision Surgery

January 20, 2020

Help us ensure women’s access to care by filling out our short online survey. Your participation in the survey will take only a minute or two of your time, and will help us understand how we can solve the problem of insurance denials for women seeking flat closure and revision services.

Recommend Your Flat Closure Surgeon!

January 18, 2020

Happy with your flat closure – whether at initial mastectomy, explant, or revision – and want to help other women going flat? Now you can recommend your surgeon for our Flat Friendly Surgeons Directory, with our easy online form!

Our Directory helps women protect their choice by connecting them with a proven flat closure surgeon in their local area who:

– respects their patients and their wishes to be flat
– are technically competent in surgical technique to achieve a flat result, AND
– do their best to give their patients their desired result

Tina – Flat Has Been Freeing

January 15, 2020

“My surgeon did confess that after being part of my choice in going flat, she too would do her best to offer ‘flat’ as a viable option for others. She witnessed that my choice was a healthy (both mentally and physically) choice made with great reflection and a well-informed education.”

Reading Tina’s story, it’s clear that she is happy with her decision and with her surgical result. She didn’t expect perfection – no one does. And Tina’s confidence had a profound effect on her surgical oncologist. She now offers flat as a viable option to her patients.

Vermont Rep. Fegard Introduces Revision Bill

January 12, 2020

Breaking news! Vermont State Representative Charen Fegard has just introduced an historic bill requiring insurance coverage for revision surgery!

This is an historic moment for the flat community. Women have had to fight their insurance companies to get revision surgery covered for far too long. It’s way past time to #putflatonthemenu.

Flat is Beautiful: Video

January 08, 2020

A new resource is up on the website – the Flat is Beautiful video presentation, featuring many amazing flat advocates and advocacy projects. This 6 minute video is an introduction to going flat as a valid, beautiful mastectomy choice.

Our Poster at SABCS 2019

January 08, 2020

We had a successful poster session at the San Antonio Breast Cancer Symposium (SABCS) this past month, presenting a poster with the results of our original research, “Flat closure after mastectomy: are your patients satisfied with the results?”

This research explored the patient experience going flat, including decision factors, satisfaction with cosmesis, provider pushback, and more. Stay tuned for the full report.

NEW – International Translations of the “Flat is Beautiful” Brochure

January 12, 2020

We are happy to announce nine new international translations of the Flat is Beautiful brochure, available now for download. Spanish, French, German, Arabic, Swahili, Russian, Chinese (simplified), Hindi, and Portuguese are the languages now available.

We extend a heartfelt thank you to Global Wordsmiths for providing translation services for this project.

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