Flat Denial: Who is Most at Risk?

We’re All at Risk, Right?

Our research, presented last year at the San Antonio Breast Cancer Symposium, has identified several probable factors that patients going flat should be aware of. While all patients going flat face some risk – roughly 2-3 in 20 end up with an egregiously poor cosmetic result and one of those is intentional denial – certain factors are associated with an increased prevalence of flat denial. These factors are: age older than 55 years, higher than normal BMI, use of a general rather than a breast specializing surgical oncologist, and presence of pre-operative pushback from the surgeon.

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.

While there are no guarantees and further studies are needed, these guidelines should help patients secure the aesthetic flat closure they expect and deserve.

Need to Find a Surgeon?

Find a patient recommended flat closure surgeon near you for mastectomy, revision or explant using our Flat Friendly Surgeons Directory. These surgeons:

  • Respected the patient and their wishes to be flat
  • Were technically competent in surgical technique to achieve a flat result, AND
  • Did the best they could do give the patient the results they desired.

No Directory Surgeons in Your Area?

Visit the information pages for Initial Mastectomy, Revision and Explant for tips, tools and more.

Want to Support Our Work?

Spread the word by sharing our work on social media or speaking to your local medical providers about flat closure. Or volunteer or donate!


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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