NCI Adds “Aesthetic Flat Closure” to Dictionary

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.

Clear Language Matters

For too long, women who choose to go flat after mastectomy have lacked clear language to use to ensure their providers understand their desires and aesthetic expectations. This lack of clarity has also led to widespread confusion and mischaracterization of flat closure as “cosmetic” (not reconstructive) and therefore not covered by insurance. And it has hampered the development of an improved standard of care that involves aesthetic consideration.

The NCI’s excellent definition of flat closure includes the following critical elements:

• flat closure is reconstructive (“rebuilding” the shape of the chest wall)
• flat closure requires an aesthetic surgical approach
• flat closure may be performed at the initial mastectomy or at explant
• excess tissue removal and contouring are involved
• the goal of flat closure is to create a smooth, flat chest wall contour

Women going flat deserve an optimal flat closure covered by insurance, every time.

This new NCI term represents a huge step forward towards achieving this goal. Our sincere thanks to the leadership at NCI for listening to women and recognizing the need for clear language on flat closure – for helping to #putflatonthemenu !

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