Tina – Flat Has Been Freeing


Editor: It’s been some months since we published our last personal story of going flat. Today we hear from Tina Rattunde, a woman who tested positive for the BRCA2 mutation after watching multiple family members deal with breast cancer. She chose to go flat in July of 2016. Her surgical oncologist wanted her to see a plastic surgeon “in case she changed her mind” about reconstruction, but Tina declined. She had made her decision: she wanted to be flat, and to be done with surgery.

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, because through Tina she learned that flat is a healthy, legitimate, safe reconstructive choice that women are happy with. Nice work, Tina! And bravo for her surgeon keeping an open mind.

Tina’s daughter Nat wrote a letter of support for her mother’s choice as well, and had some powerful words both for women facing mastectomy and for the providers who care for these women.


Tina Rattunde chose to go flat in 2016 after testing positive for the BRCA2 mutation. Her pre-op imaging uncovered DCIS.

My name is Tina Rattunde. This is a brief accounting of my journey to become flat and why I advocate for flat closure.

In October 2015, my 1st cousin was diagnosed with breast cancer. This sparked the desire to have a mammogram by my sister and myself.

We were both called back for another mammogram the same day. These tests lead to MRI’s for both of us. My sister’s tests observed multiple crystallizations in both breasts and mine showed nothing. We geared up for the possibility that hers were cancerous in nature. After her biopsy, she learned that she, in fact, did not have cancer. She chose a bilateral mastectomy with DIEP flap reconstruction in early 2016. She has since had another procedure to correct some of the fat deposits.

Effect of BRCA mutations on cancer risk
CREDIT: Cancer.gov

Why do I tell you all about my sister? Because, this is where her story ends and mine begins. As of January 2016, I thought I was good. I still chose to have a preventative bilateral mastectomy because of the family history. You see, during my sister and my ordeal, we chose to be genetically tested for the BRCA mutation. We both tested positive for BRCA2.

I arranged to meet with a breast surgeon to set up my surgery. She was a fantastic surgeon who listened to me and my want to be flat. She felt it was important to have me see a plastic surgeon “in case I changed my mind later on”. This was heartily declined. I did not want any future surgeries. I saw firsthand my sister’s 13-hour surgery and how much it took out of her to heal. I knew my cousin had expanders put in and they were so uncomfortable. (By the way, she did pass away due to complications with sepsis after her implants were placed.) With being 43 years old, having a young, active son, and knowing reconstruction would be a lifelong, repetitive issue, and not wanting multiple surgeries,  I chose to be flat.

When going in for my pre-op MRI in late June 2016, the MRI specialist found cancer. Yes, I was clear in January but now had DCIS (ductal carcinoma in situ) in my right breast. My surgeon and I decided it was best to move quickly. Surgery was scheduled for two weeks later.

So, on July 8th, 2016 I was given my flat closure as I requested. My scars were very nicely done. I did have a deep tissue infection caused by the surgery but it was taken care of without causing more dramatic scars in the surgeon’s office, thankfully. I have not had any other surgeries to adjust my breast area. I do have “dog ears” but they are minimal. I am overweight so this does affect other areas of my body’s image without my breasts, but I would never make a different choice. 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.

Flat has been a freeing of sorts to me. I no longer have to have yearly mammograms. I can easily check for any lumps or suspicious issues on my chest wall. I don’t miss the heaviness of my natural breasts. I can choose prosthetics if I do want to have the look of breasts. And, most importantly, I’m alive, well, and happy.  

This story of my sister and I shows how, just in one family, cancer and reconstruction can differ greatly. Neither is wrong. Neither makes us less of or more of a woman. We are both very comfortable with our outcomes and our choices. We both support one another on our choice. This should be the “norm” of every decision when it comes to reconstruction. When I state reconstruction, I mean the following choices: flat, unilateral mastectomy, unilateral mastectomy with reconstruction, bilateral mastectomy, bilateral mastectomy with reconstruction, lumpectomy, lumpectomy with reconstruction.

Thank you for taking the time to read this. Please consider every option when having to make these tough decisions in life. Be YOUR best advocate! No one wants cancer. Let’s do all we can to promote healthy choices for those who may be cancer’s next victim. Whether it is the option of PREVENTATIVE or LIFESAVING measures, let’s not think of just the here and now. Let’s think ahead to the future generations looking at us, waiting for us to do our best for them, no matter what that looks like!


Tina’s daughter Nat writes:

“I am a 26 year old woman. I may very well have to face [the situation my mother and aunt faced] in the future. I also know that just because it is currently the accepted course of action to recommend reconstruction and ignore (at best), or actively discourage, remaining flat after the mastectomy, women do not need to silently accept this treatment.

This line of thinking is indicative of our societal frame of mind that women are sexual objects and without breasts, are not acceptable. My mother is no less of an attractive woman without her breasts. My aunt is no more of an attractive woman after reconstruction. I am no more attractive than both with natural breasts.

Breasts, or a lack of them, do not define our value or who we are. Whether anyone chooses to have flat closure, they are entitled to a safe, unbiased, and aesthetically pleasing surgery.” – Nat Rattunde 

Breasts, or a lack of them, do not define our value or who we are. Whether anyone chooses to have flat closure, they are entitled to a safe, unbiased, and aesthetically pleasing surgery. 

I am incredibly blessed to be in a family that supports our right to choose what is best for our own body. I have watched how horrifying the choice is to make, yet because of the support we have for one another, this choosing was completed without guilt or shame. There is no universal right choice for what to do with your body after cancer or to prevent it... I fully, and without any semblance of hesitation, support the reformation of legislature and societal norms to reflect women having true autonomy over their bodies and flat closure for those who want it.

And whether that includes me or not, I will continue to support a woman’s choice to have medical procedures that are healthy, unbiased, and a reflection of their best interest.”


Editor: Well said, Nat! We thank you, and we support you!


Published by Not Putting on a Shirt

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

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