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


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.


Charise Isis (The Grace Project)

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 Show, Bust Magazine, Medical Daily, and more, and recently achieved 501(c)(3) status as a registered nonprofit.


Editor: Because Charise is a flat advocate but not herself a breast cancer survivor, this post is presented as an essay. We honor Charise and her ongoing work.

I am not a breast cancer survivor. I am the photographer, founder and executive director of The Grace Project. The Grace Project is 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. As such, I have been witness to the physical and emotional scars of hundreds of people across the United States who have had mastectomy surgery. Their bodies are as diverse as their surgical outcomes and I have listened to many stories of both pain and triumph.

I believe that what a person chooses regarding reconstruction after a breast cancer diagnosis is an extremely personal decision. Unfortunately, a breast cancer diagnosis is somewhat comparable to a tornado suddenly sweeping into one’s life. There is little or no time for preparation or consideration. In the blink of an eye, you are under the surgeon’s knife, the  consequences unwrapped after the fact when the surgical bandage is removed.

If I were to experience a breast cancer diagnosis at this time in my life, I would most likely choose flat closure for myself. I can’t tell you this for sure, because in truth, a real decision is made on the head of a pin… but I am a person who has witnessed the widest variety of results, and I’ve observed how people feel about those results and the lingering and ongoing side effects of their decisions.

It is my belief that EVERY surgical option and the physical consequences of those options should be presented to a woman prior to her surgery, and that she should be allowed as much mental space as possible to contemplate those results without the social implications that fall under the personal opinion of a doctor. The doctor needs to remain neutral in the presentation of all options, including, and perhaps especially, flat closure. It is hard enough for a woman to decide what SHE really wants for her own body, let alone factoring in the opinions of her partner, her lifestyle and her body type without the added pressure of how her surgeon, who likely doesn’t know her at all, feels her life would proceed with her given choice.

I have become a voice for the flat closure movement because I inherently feel that women should have autonomy over their bodies. I have heard countless stories from women that I know were not given the option to go flat, or even the option for DIEP flap surgery but were railroaded by their doctors to have silicone reconstruction.

I know women who, upon choosing flat closure reconstruction, were forced to meet with a psychiatrist before being allowed that option, whereas a woman choosing silicone reconstruction was not subjected to the same scrutiny. 

I know young women whose doctors told them that no one would want to date them if they chose to go flat; and women whose surgeons overrode their decision for flat closure and left them with skin-saving fat pockets against their medical wishes “in case they change their mind”. 

I even have a friend who was having excruciating pain with her implants, which were also the type that were being recalled for toxicity. Her surgeon complained that by having them removed and opting for flat closure, she was going to destroy his masterpiece. 

All of this is unacceptable.

Every October, and beyond, we are assaulted with pink ribbons and breast cancer awareness. Let’s face it, there is no lack of awareness in the United States or other developed nations that breast cancer exists. However, having been immersed in the breast cancer world for as long as I have, I’ve become invested in creating awareness around issues that I believe are flagrantly ignored. Issues such as the fact that black women with breast cancer in the U.S. have a significantly higher mortality rate than their white counterparts, or that metastatic breast cancer gets very little funding even though it is the only stage of breast cancer that kills.  Raising awareness for flat closure has become one of the issues that I feel desperately needs to be addressed.

Through my photographs and stories, I have become a voice for my friends, the gorgeous and diverse tribe that is united under the banner of breast cancer. The photographs I share tell stories of pain and triumph and bear witness to the indomitable human spirit and the beauty and grace that lives within… they reveal that we are perfect in our imperfections.

… and my photographs are evidence that a perfect set of breasts do not equal beauty.


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!


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.


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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