2020 Archive

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Memorializing your breasts before mastectomy

Before Your Surgery: Memorializing Your Breasts

December 13, 2020

You may want to consider memorializing your breasts before your surgery. Then after your mastectomy, you will have something tangible with which to remember and honor your previous breasted body. 

New Resource! Preparing for Surgery

December 08, 2020

New resource at NPOAS for women facing surgery! Preparing for your mastectomy with aesthetic flat closure can be an undertaking – it helps to know what to expect. This illustrated resource includes a pre-surgery checklist, supply list, recovery tips from patients who have been there, FAQ, and more. Visit the Preparing for Surgery and please share for women in your life who are facing mastectomy surgery.

Meet Our Advisors: Minas Chysopoulo, MD, FACS

November 28, 2020

Dr. Chrysopoulo is a board certified plastic surgeon specializing in autologous breast reconstruction. He is the President of PRMA Plastic Surgery, and has authored and coauthored several articles and book chapters. Dr. C is also the founder of the Breast Advocate, which is a great tool to help for patients facing breast cancer surgery understand their reconstructive options.

Meet Our Advisors: Corine de Boer, MD, PhD

November 21, 2020

Dr. de Boer’s assistance was invaluable in getting our 2018 and 2019 Survey data presented at the San Antonio Breast Cancer Symposium in December 2019, and she has also assisted in reviewing information we provide on this website. Thank you, Dr. dr Boer, for your help as we work together to #putflatonthemenu!

Action Alert! Flat Closure Study Recruiting Participants

November 14, 2020

Investigators at Hofstra University are conducting a qualitative study looking at how going flat affects quality of life. It’s easy to participate – just schedule a 30-60 minute Zoom interview to speak with investigators about your experience. Contact Kellie Cronley (kelliecronley3@gmail.com) to sign up, or for more information.

Meet Our Advisors: Yara Robertson, MD, FACS

November 13, 2020

Dr. Robertson is a breast surgical oncologist who has been practicing in Atlanta, GA since 2011. She is passionate about eliminating disparities in breast cancer treatment, especially in the African American community. She has also served as Vice-Chair of Sisters by Choice and is a kidney cancer survivor herself. She’s a strong advocate for patient choice and shared decision making as well.

Louise: My Surgeon Refused to Even See Me

November 05, 2020

Editor: Louise had to fight her surgeon to get the single mastectomy she wanted, instead of the lumpectomy her surgeon wanted. She suffered a serious complication, a persistent seroma, which affected her aesthetic result. Later, when she inquired of her surgeon about revision, instead of referring her to a plastic surgeon… he simply refused to see her. Louise was crushed because she was so unhappy with her aesthetic result and was now, essentially, being told there was nothing to do about it. Then she came across  NotPuttingonaShirt.org and realized that she deserved better. Louise is currently awaiting her revision surgery with a new doctor.

Meet Our Advisors: Rep. Charen Fegard (D-VT)

November 01, 2020

New Series: Meet Our Advisors

Our Advisory Council consists of leaders in the professional community who have generously donated their time and expertise to advise the “Not Putting on a Shirt” Board of Directors. We sat down with them to talk about who they are and why they support aesthetic flat closure.

Today we talk to Rep. Charen Fegard (D-VT) (Legislative Advisor). Charen earned a Bachelors degree in Biology from the University of NC at Wilmington. She has worked in the Civil Service and at several nonprofits, and currently serves as a House Representative in Vermont. She also runs a busy homestead! Charen is a strong supporter of aesthetic flat closure and of NPOAS’ work.

Progress: Marie-Claude Belzile’s Petition Gets Traction in Québec’s National Assembly

October 29, 2020

Thanks to the pioneering work of Québec advocate Marie-Claude Belzile of Tout aussi femme (who is also a member of our Council of International Advocates), the main online French-English translation database for Québec, Grand dictionnaire terminologique, has included “mastectomie à fini plat” (the French analogue of aesthetic flat closure) since mid-2020. And now, her petition (sponsored by Assembly member Christine Labrie of Québec solidaire) to ensure women in the province receive full information about all of their reconstructive options is getting major traction in the Québec National Assembly!

October 29, 2020

Looking for flat closure photos? Visit our Photo Gallery page to view all kinds of aesthetic flat closure images – initial mastectomy, revision and explant, flat denial, and mastectomy tattoos. Includes a lifestyle section with links to the many flat and body positive personal and professional projects available on social media!

This resource will assist patients and providers in the shared decision making process by providing a variety of images to facilitate a mutual understanding of the patient’s expectations. We add images to the Gallery on a regular basis. You can submit your flat closure photos here.

Survivornet: “To Reconstruct or Not”

October 29, 2020

“Kathy Reed always knew that if she ever had to have a mastectomy, she would not have breast reconstruction. She would live flat. She knew this long before she was diagnosed with breast cancer at age 44 in 2003.” – Sonya Collins for SurvivorNet

Kathy’s surgeon, despite her confidence in her decision, left “a little extra in case you change your mind.” Sounds familiar: this is intentional flat denial. Kathy decided against additional surgery and has lived with the results of her initial surgery for over fifteen years.

Mind Bloom Podcast: NPOAS’ Devorah Vester on Going Flat (Aesthetic Flat Closure)

October 29, 2020

Executive NPOAS team member Devorah Vester spoke Mind Bloom host Marina Gee about her cancer experience and going flat, informed consent, and what sourdough baking can teach us about how to weather life’s challenges. Episode 24: “Not Putting on a Shirt, with Devorah Vester” is available on Google Podcasts or wherever you get your podcasts!

New Resource! “Living Flat”

October 25, 2020

For women who have recently gone flat and are adjusting to their new bodies, we now have a resource page up that covers how to find community support, flat fashion, body image & sexuality (including 20 or so body-positive flat visibility projects), prosthetics, mastectomy tattoos, a collection of articles and videos about going flat, words of wisdom from women who have been there, and more! Check it out at  NotPuttingonaShirt.org/LivingFlat.

Breast Cancer United: Walk With Us This Nov. 27th

October 25, 2020

Big news! NPOAS has joined Breast Cancer United, a movement garnering the collective strength of over 50 leading breast cancer organizations, on a mission to eradicate breast cancer. We have joined forces, uniting as one to show the world that breast cancer exists far beyond pink ribbon campaigns and the month of October.

Going Flat Story Featured in Florida Local Newspaper

October 18, 2020

Aesthetic flat closure in the news! AmySue Benker of Naples, FL tells her story, including how she decided to go flat. Read HERE.

Juliet Fitzpatrick in Vogue UK

October 18, 2020

Vogue UK just published Juliet Fitzpatrick’s story! Read HERE. Three other survivor’s stories are also featured, including Rime Hadri who went flat after her unilateral mastectomy. Photos are from a London-based photography project called “Behind the Scars” by Sophie Mayanne, which celebrates scars of all shapes and sizes, and the incredible stories behind them, encouraging people to celebrate the skin they’re in.

Carine (France) Speaks Out About Fighting to Go Flat

October 17, 2020

Via Pascale Contrino of Complètement FEMME – l’audace d’être entière après une mastectomie (and a member of our Council of International Advocates)

From France, Carine speaks out about her choice to explant with aesthetic flat closure (“reconstruction à plat,” or “fermeture esthétique à plat”). After her diagnosis in her 40’s, she had to fight for her CPM (contralateral prophylactic mastectomy, or removal of the other, “healthy” breast) and was not offered the option to go flat. Her initial implant reconstruction was extremely uncomfortable, and after nine months she found Marie-Claude Belzile‘s work at Tout aussi femme and felt empowered to have one last surgery: explant to flat.

Mollie Hartford: This Breast Cancer Awareness Month, think beyond pink

October 17, 2020

Mollie in MA wrote this incredible article about the need to focus on our resources on metastatic breast cancer research for better treatments and a cure, and also threw this in for good measure:

“Plus, not everyone chooses reconstruction. Ask me about “aesthetic flat closure” or “going flat” (and how it’s a struggle to get doctors to believe it’s what we really want).”

October 13th is Metastatic Breast Cancer (MBC) Awareness Day

October 17, 2020

Repost from International FLAT Day

[October 13] Today, October 13th, is Metastatic Breast Cancer Awareness Day. MBC is the only breast cancer that kills. Ten percent of new BC diagnoses are “de novo” metastatic, and about 1 in 3 early-stage diagnoses will progress to MBC.

Marissa Holzer (USA) wrote this article for CURE magazine to highlight #aestheticflatclosure, #InternationalFLATDay and #MBCAwarenessDay.

NEW! Media Kit – Aesthetic Flat Closure

October 17, 2020

Now available! Our Media Kit page has fact sheets, a press FAQ, photos and promotional graphics, backgrounder, press releases, and more! Everything you need to know about #aestheticflatclosure.

Welcome to the Council of International Advocates: Ngozi Ejedimu

October 17, 2020

We are thrilled to welcome Ngozi Ejedimu, founder of What Cancer Naija and The Judah Foundation for Breast Cancer, to our Council of International Advocates! Ngozi is a lawyer turned entrepreneur and breast cancer advocate educating women in Nigeria (and beyond) about the need to be breast aware and taking charge of their own health. She was diagnosed with BC and went flat in 2016. Welcome, Ngozi!

Feature Friday at Surviving Breast Cancer.org – “Going Flat”

October 17, 2020

Thanks to Survivingbreastcancer.org for helping us spread the word! If you are facing mastectomy and have decided to go flat, be sure to ask your surgeon for an “aesthetic flat closure” as defined by the National Cancer Institute… and make sure it’s in your medical record.

“I Dissent” – Our Secretary’s Message for #IFD2020

October 17, 2020

[October 7th] NPOAS Secretary Devorah has a message for the world on this  #InternationalFLATDay!

“RBG said, ‘Fight for what you believe in.‘ This is what I do every day. I fight for truth, justice and equality for people who live with mental illness. I also fight for full and fair disclosure of all post-mastectomy options, including flat aesthetic closure, so that women like me can make an informed decision and give informed consent that works for them. RBG also said, ‘I dissent.’ And I say that too.”

Yahoo! Life – Article on Flat Advocacy & the NCI Term “Aesthetic Flat Closure”

October 17, 2020

Hot off the press! Beth Greenfield’s article for Yahoo Life about the great strides flat advocacy has made in recent years! Let’s keep up the good work to #putflatonthemenu and make sure women are empowered to advocate for their choice – #aestheticflatclosure!

[Video] “Flat Visibility 2020”

October 17, 2020

This beautiful, powerful awareness video was made by and for the flat community with the hope it reaches far and wide. “Stand Tall” this breast cancer awareness month and support research for a cure. Produced by Flat Retreat@LessThanTwoBreastsLinkage Beauty Movement and @StatisticalOddity. View in HD here.

German Flat Advocacy Podcast – AMSOB.de

October 17, 2020

[October 7th] The advocates at Ablatio Mammae – selbstbewusst ohne Brust have an incredible new podcast out! In today’s International FLAT Day episode, host Kerstin Grotelüschen discusses aesthetic flat closure, flat visibility and informed consent with guests from around the globe. Listen at the AMSOB website!

Going Flat, Self Acceptance & Body Image – Panel Discussion for Komen MBC Conference

October 11, 2020

Rebecca Pine (The Breast & The Sea) presents a panel discussion on going flat, self-acceptance & body image at the virtual 2020 Metastatic Breast Cancer Conference (organized by Susan G. Komen). Panelists include Marianne DuQuette Cuozzo Artist and Kimberly Bowles (NPOAS).

“Aesthetic Flat Closure: Know Your Options” – SHARE Cancer Support Webinar

October 11, 2020

All about aesthetic flat closure – a webinar brought to you by SHARE Cancer Support! Panel includes Dr. Yara Robertson and Kimberly Bowles of NPOAS, and Jersi Baker of Angel in Disguise Inc.

Aesthetic Flat Closure on the NYBRA Plastic & Reconstructive Surgery!

October 11, 2020

Plastic surgeons are spreading the word – aesthetic flat closure. Our sincere thanks to Directory surgeon Dr. Ron Israeli and the team at NYBRA Plastic Surgery, including Drs. David Light & Jonathan Bank, for taking the next step forward towards parity! #flatfriendlysurgeons

“… some women opt not to have a breast reconstruction, but that doesn’t mean that they’re opting not to have an aesthetic appearance to their chest, and this is basically what an aesthetic flat closure is defining.” – Dr. David Light, MD

DiepC Interview with Terri Coutee about Optimal Flat Closure

October 10, 2020

Breast reconstruction advocates and advocates for flat closure share the same goal: to ensure that women are fully informed of ALL of their reconstructive options so that they can make the choice that’s right for them. Kim recently spoke with Terri Coutee of DiepC Foundation about going flat after mastectomy and the importance of informed choice.

Progress in Québec: “Mastectomie à fini plat”

October 10, 2020

Progress in Québec! Their online French-English translation database, Grand dictionnaire terminologique, now includes “mastectomie à fini plat“, the French analogue of aesthetic flat closure!

The new term is translated literally as “mastectomy with flat finish”.

Thanks to advocate Marie-Claude Belzile of Tout aussi femme (who is also a member of our Council of International Advocates) for her hard work on this to protect the interests of women going flat!

Pioneers in Flat Advocacy: Samantha Paige (Last Cut Project)

September 30, 2020

Samantha (Sam) Paige is an artist, mother, young thyroid cancer survivor, and BRCA-1 previvor who lives in Los Angeles with her daughter. She initially reconstructed with breast implants after her prophylactic double mastectomy, but never felt comfortable with them. After eight years feeling “detached” from her body, she decided to explant and go flat. It was during this period of intense change and renewal in her life that she created Last Cut Project, a multimedia documentary project about asking the big questions in life and taking a look at our significant decisions (“last cut moments”). Sam is also an inspirational speaker, and recently published her first book, Last Cut (10% of proceeds benefit teen literacy nonprofit Get Lit). Sam has been featured in Equinox’s “Commit to Something” campaign, PeopleAllureSHAPEUSA Today, and more.

Announcing our Council of International Advocates

August 31, 2020

Flat advocacy is a global movement, with a common purpose. The Council of International Advocates at NPOAS consists of leaders in the flat advocacy community worldwide who have come together cooperatively to #putflatonthemenu for our mothers, sisters, friends, and daughters. We are stronger together! Meet our Council Members at the Council Page.

Mastectomy Tattoos with Artist Amy Black

August 30, 2020

Healing Through Art. Tattoos can be an important component of healing for many women following their mastectomy surgery – both those who chose to reconstruct their breasts AND those who chose to go flat. Tattooing can be a way for women to take back ownership over their bodies, having had so little control during breast cancer treatment.

Spread the Word! Aesthetic Flat Closure (VIDEO)

August 25, 2020

Please share this video, so that those facing mastectomy who don’t want breast mound reconstruction know what to ask for! Aesthetic flat closure.

ReThink Article Aesthetic Flat Closure

Why I Advocate for Aesthetic Flat Closure

August 17, 2020

Canadian advocacy organization ReThink Breast Cancer focuses on the needs of young women facing breast cancer in their legislative and other advocacy initiatives. They also publish thought-provoking blog posts from survivors, thrivers, advocates, and providers on all things breast cancer-related. They just published our guest post on advocating for aesthetic flat closure!

Advocating for Women Who Choose to Go Flat After Mastectomy

August 13, 2020

The National Coalition for Cancer Survivorship (NCCS) just published our guest post about aesthetic flat closure!

Who amongst you will argue that women who decide to go flat instead of pursuing conventional breast reconstruction don’t deserve a decent aesthetic result they can live with? No one. This is not a question of vanity. This is about dignity.

Your Killer Life Podcast: Aesthetic Flat Closure

August 04, 2020

Kim spoke with host Tammey of Your Killer Life about informed consent, her personal story of flat denial, aesthetic flat closure as a valid reconstructive option, how women can advocate for their choice, and resources we have available for women facing mastectomy, revision, or explant surgery. Available where you get your podcasts. Now also available to watch on YouTube.

July 29, 2020

NPOAS President Kim Bowles spoke with Stacie-Rae, professional restorative tattoo artist, innovator, and quality advocate. They discuss aesthetic flat closure, informed consent in medicine, managing expectations, and advocacy strategy.

Pioneers in Flat Advocacy: Nikki “Trip” Tripplett

July 27, 2020

Nikki “Trip” Tripplett was diagnosed with multifocal breast cancer at age 36, in 2015. She had a strong family history of breast cancer, and had the full battery of treatments – chemo, single mastectomy followed by contralateral mastectomy, radiation, and more surgery. Trip lives in Texas with her longtime partner, Unique, and is a runner, influencer, entrepreneur, and breast cancer advocate. In 2018 she walked the runway during NY Fashion Week 2020 for the #Fearless fashion show by #Cancerland and #AnaOno benefitting Metavivor – she also interviewed other participants. She was interviewed on Houston’s Isaiah Factor Uncensored about her experience. Trip has worked extensively with the Young Survival Coalition to fundraise, provide support programs to cancer survivors, represent her community and get information about breast cancer into the community discourse, and has been featured in both Forbes and Glamour Magazine. Find her on Instagram at @ThatDamnTrip and on Instagram and Facebook @TheCancerPreneur.

My Body, My Choice: Aesthetic Flat Closure After Mastectomy

July 27, 2020

Our Bodies Ourselves  published our guest post about aesthetic flat closure!

Thanks to Our Bodies Ourselves for helping spread the word about aesthetic flat closure! This pioneering organization has worked to promote women’s health and bodily autonomy for decades. Every woman facing mastectomy deserves full and fair disclosure of all of her reconstructive options, and for her choice to be respected.

Summary of Our Flat Closure Research from #SABCS19

July 19, 2020

NPOAS presented our poster at the 2019 San Antonio Breast Cancer Symposium (#SABCS19) last December. This research explored patient experience going flat, including decision factors, satisfaction with aesthetic flat closure cosmesis, provider push back, and more. Our abstract – the summary of our important findings – is now available online at the American Association for Cancer Research (AACR):

“Flat closure after mastectomy: are your patients satisfied with the results?”

What if I want to go flat, but my surgeon wants to do “skin sparing”?

July 11, 2020

Tell your surgeon you want an “aesthetic flat closure” as defined by the National Cancer Institute – and make sure it’s recorded in your medical record.

Visit our website for tools and resources to help you advocate for your choice to go flat. Find a Flat Friendly surgeon in your area, and print out one of our helpful brochures for use in consult!

#notputtingonashirt infographic - Susan Love Foundation adds "aesthetic flat closure" to their website

Aesthetic Flat Closure – Word is Spreading!

July 07, 2020

Pioneering breast cancer research organization, the Dr. Susan Love Research Foundation, has added “aesthetic flat closure” to their webpage on breast reconstruction options! This is just the beginning. We expect to see online platforms adopt this new term quickly as word continues to spread.

Aesthetic Flat Closure is now on Wikipedia

July 04, 2020

More good news. Spread the word! Aesthetic flat closure is now on Wikipedia, the open-source online encyclopedia!

Spread the Word: Aesthetic FLAT Closure

July 03, 2020

For all those facing mastectomy who don’t want breast mound reconstruction…

Going FLAT? Let’s Be Clear.

Tell your surgeon you want an “aesthetic flat closure” as defined by the National Cancer Institute so your surgeon will know exactly what you want: a smooth, flat chest.

Spread the word!

Share our infographic on social media. Don’t forget the hashtags!

Prof. Abigail Bakan Publishes Treatise on Going Flat & the Politics of Choice

June 30, 2020

Professor of social sciences and social justice education at The University of Toronto, Abigail Bakan just published her in-depth and insightful feminist analysis of the situation women face after being diagnosed with breast cancer today. She addresses the insidious narrative of “going flat” as an inferior choice, head on, and her writing is informed both by personal experience and by her study of and interaction with the flat advocacy movement. Read the full article here. Thank you Prof. Bakan and Imaginations for working to #putflatonthemenu !

How We Do It

June 29, 2020

Announcements of major milestones for flat parity – like the Oncoplastic Breast Consortium adding “optimal flat closure” to their mission statement, or the National Cancer Institute adding “aesthetic flat closure” to their Dictionary of Cancer Terms may seem like they drop out of the sky, like manna from heaven.

But these announcements are just the tip of the iceberg. Behind the scenes are months to years of tireless, diligent, creative work. Successes, failures, obstacles overcome, lessons learned… and never, ever giving up. That’s how we do it. We will always be grateful for the flat advocates whose work created the foundation for our successes in 2020 and beyond. Here’s a glimpse of some of the “inner workings” at NPOAS as we continue to push for progress – and a look at what the future holds.

BISA’s Petition for ICD-10 for Breast Implant Illness

June 27, 2020

Please join us in signing Breast Implant Safety Alliance‘s petition to the FDA & CDC to create much needed medical coding to support women – both reconstructed after mastectomy and augmented – seeking therapeutic explant. NPOAS supports evidence based research and clinical practice to serve all women seeking flat closure. Clear coding is critical! SIGN THE PETITION HERE.


June 27, 2020

NPOAS stands in full solidarity with the Black community against racism & injustice. The right to bodily integrity is universal and all-encompassing, and there is no greater violation than the taking of an innocent life.

Flat Friendly Surgeons Directory Milestone!

June 27, 2020

Celebrating a milestone! We now have over *200* surgeons recommended for mastectomy, revision and explant on our Flat Friendly Directory! A big THANK YOU to each and every one of our surgeons, and to the women who so generously shared them with us.

Dr. Attai’s Flat Closure Research Poster

June 27, 2020

Dr. Deanna J. Attai ‘s (UCLA) flat closure research results just went live at the virtual poster session from #ASBRS2020! The research team – including Drs. Jennifer Baker (the PI, at UCLA) and Don Dizon (Lifespan Cancer Institute of RI), found that a whopping 30% of patients reported that their surgeon did not support their choice to go flat, and even more patients (36%) reported that flat was not offered to them as an option at all. Close to 3/4 reported being satisfied with their surgical outcome (NPOAS’ own research found a very similar satisfaction rate).

Patient Power Publishes Article on Going Flat

June 27, 2020

Patient Power – a Cancer Community just published a great article exploring the choice to go flat after mastectomy, and the risk of flat denial. Patient Power is a nonprofit organization dedicated to keeping cancer patients up to date on issues relating to their treatment and survivorship, founded by medical journalist and cancer survivor Andrew Schorr and his wife Esther.

MWB Podcast Features Flat Closure

June 27, 2020

Now you can listen to the reconstructive surgeons at Midwest Breast & Aesthetic Surgery discuss flat closure as an aesthetic reconstructive option on their new podcast, The Breast Podcast Ever! Available on Apple, Spotify, and YouTube. A big THANK YOU to Drs. Tiwari and Kocak for being a voice for women!

Share Your “Going Flat” Story

June 27, 2020

Amplifying Women’s Voices

NPOAS has been publishing women’s stories on our blog since our inception in July 2018. Women facing mastectomy are edified, and providers are educated. Our aesthetics matter. We matter. Share your story today at NotPuttingonaShirt.org/YourStory

Pioneers in Flat Advocacy: Catherine Guthrie

May 29, 2020

Catherine Guthrie is a women’s health journalist whose work has appeared in dozens of national magazines from O, The Oprah Magazine to Time Magazine to Good Housekeeping. She was diagnosed with breast cancer at age 38 and elected a double mastectomy, rejecting reconstruction in favor of preserving her physical strength and bodily integrity. Her queer, feminist cancer memoir, FLAT: Reclaiming my body from breast cancer, was published in 2018. Catherine appeared with NPOAS founder Kim Bowles on the Today Show to discuss her exposé on flat denial for Cosmopolitan Magazine. Listen to her NPR interview or visit her website to learn more.

NCI Adds “Aesthetic Flat Closure” to Dictionary

June 27, 2020

Another Step Towards Parity

The National Cancer Institute, a division of the National Institutes of Health (NIH), has just added “aesthetic flat closure” to its official Dictionary of Cancer Terms, defining it as a reconstructive and aesthetic surgical procedure.

aesthetic flat closure
(es-THEH-tik flat KLOH-zher)
A type of surgery that is done to rebuild the shape of the chest wall after one or both breasts are removed. An aesthetic flat closure may also be done after removal of a breast implant that was used to restore breast shape. During an aesthetic flat closure, extra skin, fat, and other tissue in the breast area are removed. The remaining tissue is then tightened and smoothed out so that the chest wall appears flat.

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.

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.

February 22, 2020

** Update: unfolding information suggests that this situation does not represent flat denial. It may represent a violation of consent, but we do not have all the facts. This patient consented to direct to implant reconstruction. Instead of placing an implant, the surgeon placed an expander. We will update when we have more conclusive information. **

(Australian Woman Says Her Surgeon Placed Expanders 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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