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 those that followed.
Juliet Fitzpatrick
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.
When you were making your reconstructive choice, how did you end up choosing flat?
“I was told that I needed a single mastectomy in February 2016, and at the same time it was assumed that I would have a DIEP reconstruction. I agreed and over the next few days, realized that I didn’t want reconstruction because of the length of surgery and the look of the end result. I asked my surgeon to do a bilateral mastectomy but he refused, so I ended up as a uniboober with a remaining GG cup breast. I kept asking for a second mastectomy for symmetry and finally my surgeon agreed eighteen months later.”
How has your surgical result affected your healing process moving forward?
“I’m mostly happy with both of my surgical results. I do have excess skin under both arms, but I can live with this. I had a small revision surgery on my left scar to remove a tissue flap in the middle of my chest. The fact that both of my scars are flat and smooth has really helped me to move forward both physically and psychologically.”
How did you decide that you wanted to be an advocate?
“I became a flat advocate in February 2018 after I’d had my second mastectomy and I’d done my first topless flat photo shoot. I started my blog with those photos and my first post was about my journey to living as a flat woman.
“I never planned to become an advocate, but I was alarmed that my medical team assumed that I wanted to have reconstructive surgery. The alternative – to remain flat – was never given to me as an option. I believe strongly that all treatment options should be offered to patients at the time of their mastectomy. I had to fight hard to be “allowed” to have my remaining breast removed and I wanted to highlight that these two situations happened to me.
“I want to let other women know that they don’t have to go with what their medical team says they should do if it’s not what they want. We need to know all of the options if we are to make an informed choice. My friend took some topless photos of me and I started a blog. The positive response that I got to my first post encouraged me to do more to break down the taboo around living flat and to highlight some of the medical professionals’ attitudes to a woman’s right to choose.”
What is your proudest accomplishment as an advocate?
“Being featured in the Dove #ShowUs project this year. My flat topless image was used all over the world in press and advertising billboards including Times Square and Piccadilly Circus. I was proud to be getting flat representation out across the world.”
What has been your biggest challenge as an advocate?
“Keeping the momentum going as someone working solo.”
What have you learned as an advocate that you would like other advocates to know?
“That it’s hard work and you must be prepared to put yourself in situations that may be uncomfortable. You will receive positive feedback most of the time but you should be prepared to receive criticism from unexpected sources.”
What is your vision for flat advocacy generally? What do you want the future to look like for women going flat?
“My vision is for all flat advocates worldwide to collaborate with each other so that our message can be strong and united. The more we speak out together, the further our message will get and the more we can influence the medical professionals in so many ways. To listen to women, to respect our choices, to understand that we have agency over our bodies, to know that we know what we want to happen to our bodies. It’s important that flat advocates get disseminated the message that women are more than their breasts and that many of us don’t want to have surgery to restore our bodies to what they were before mastectomy – it’s an impossible solution.
“In the future I would like women to be listened to. Whether that’s to hear when women say that they don’t want reconstruction or when they say that they want a totally flat surgical outcome. No woman should be left with pockets of skin ‘in case they change their minds about reconstruction’.”
Photo Credit: Sue Lacey 
Photo Credit: Sue Lacey 
Photo Credit: Sue Lacey 
Photo Credit: Sophie Mayanne for Behind the Scars 
Photo Credit: Sophie Mayanne for Behind the Scars
A pioneer may start as a lone voice in the wilderness, but their passion for and commitment to their cause inspires others to join them. This has led to exponential growth in the field of flat advocacy over the last decade or so. In 2020, we have flat photography projects, full length memoirs, nonprofit organizations, communities on social media, and even gatherings across the world… all made possible by the work of the advocates who blazed the trail.
If you know of a pioneer in flat advocacy that you’d like to see featured, please let us know!
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Disclaimer: Any and all information published by Not Putting on a Shirt (NPOAS) on behalf of a third party is for informational purposes only and should not be taken as a substitute for medical or legal advice from a licensed professional. Views expressed and claims made by third parties do not necessarily represent the views of NPOAS.