Pioneers in Flat Advocacy: Samantha Paige (Last Cut Project)

Pioneers in Flat Advocacy - Samantha Paige Last Cut Project - aesthetic flat closure valid beautiful

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.


Samantha Paige (Last Cut Project)

Samantha (Sam) Paige is an artist, mother, young thyroid cancer survivor, and BRCA-1 previvor who lives in Los Angeles with her daughter. She initially reconstructed with breast implants after her prophylactic double mastectomy, but never felt comfortable with them. After eight years feeling “detached” from her body, she decided to explant and go flat. It was during this period of intense change and renewal in her life that she created Last Cut Project, a multimedia documentary project about asking the big questions in life and taking a look at our significant decisions (“last cut moments”). Sam is also an inspirational speaker, and recently published her first book, Last Cut (10% of proceeds benefit teen literacy nonprofit Get Lit). Sam has been featured in Equinox’s “Commit to Something” campaign, People, Allure, SHAPE, USA Today, and more.


When you were making your reconstructive choice, how did you end up choosing flat?

“I initially chose reconstruction with silicone implants with my preventive double mastectomy in 2008. When I was facing surgery, I was presented by my surgeon with the primary choices of silicone implants versus saline implants. The option of going flat was not presented as a viable one, and certainly was not discussed without bias. The conversation was very much around how most women, as well as their partners, were happiest with reconstruction and spoke to going flat with a negative overtone. I recall asking for the possibility of a DEIP flap reconstruction to avoid the implants, but was told I did not have sufficient body fat. There were whispers within me to make a different choice. However, I had not seen or been part of discussions around flat being a strong and viable option. 

“In 2016, after having lived unhappily with the silicone implants for 8 years, I opted for an explant surgery. I had felt unwell and was not happy with how I looked (even though my reconstruction had gone beautifully) for years. Finally, after contracting a MRSA staph infection, I took action. After booking my explant surgery, I discovered Vonn Jensen’s Flattopper Pride account, which finally offered visual representation to what I had been desiring and wanting for myself. “

How has your surgical result affected your healing process moving forward?

“After my explant surgery, I finally feel well and at home in my body. Removing the implants has allowed me the space, literally and figuratively, to heal from prior surgeries and medical experiences. I feel embodied and whole. I am strong and well. I finally feel like myself.”

How did you decide that you wanted to be an advocate?

“There was something within me that knew I wanted to share my explant process from the moment I made the decision to have that surgery. The day I booked the surgery was the day that I started Last Cut Project and asked Lisa Field to photograph me. I was saddened by the way my choices had been presented to me years prior. I hoped that by sharing my own story with raw openness, I would afford someone else the opportunity to make a more holistic and balanced choice for themselves. There is no right choice for any unique body. However, there is right presentation of full and unbiased information around these choices we make. There is also a need to remove any stigmas around the differences that all bodies exhibit and experience.”

What is your proudest accomplishment as an advocate?

“I was honored to model in and bare my flat chest with mastectomy scars for Equinox’s 2017 Commit to Something campaign. When I was able to stand with my daughter on Sunset Boulevard in Los Angeles underneath a 10-story billboard of that campaign, I felt great pride in my ability to exist in a body that feels like my own. Modeling that to my daughter every day is a goal and a privilege. More broadly, all of my work and willingness to share my own story of going flat through Last Cut Project is in an effort to let others know it is brave and courageous work to stay connected to one’s own truth through any and all of life’s challenges.”

What has been your biggest challenge as an advocate?

“I would say the biggest challenge as an advocate is to remind others consistently that my story is mine, and theirs is theirs. We all have to pave our own way. We can learn from and with each other, but these are very personal matters. There is no right way other than to remain radically honest with oneself.”

What have you learned as an advocate that you would like other advocates to know?

“There is incredible value in humbly and honestly sharing your story. Doing so is shifting the tides of what is shown in the media and what is considered when others face these same choices.”

What is your vision for flat advocacy generally? What do you want the future to look like for women going flat?

“I hope that every human who faces these choices with their bodies will be met with honest, unfiltered and unbiased information so that they can make informed decisions that are connected to their truest self. I envision that we will continue to see bodies of all shapes, colors, abilities and experiences in the media.”


All images below are credited to photographer Lisa Field for Last Cut Project

Visit the Last Cut Project website to get your copy of Sam’s book today & use code NOSHIRT40 to claim your 40% discount!


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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