NPOAS 2022-2023 Two Year Strategic Plan

Here’s our detailed aesthetic flat closure advocacy roadmap for the next two years, give or take, broken down by category. Join our mailing list, or follow us on social media to stay in the loop. Contact us with questions, comments, or ideas – we’d love to hear from you!

Target: WHCRA (Women’s Health & Cancer Rights Act)
  • Push through state legislation to require insurance coverage of aesthetic flat closure services and further codify the term “aesthetic flat closure.”
  • Organize research into nationwide prevalence of insurance denials for flat closure and revision services to quantify how widespread the problem is.
  • Continue to build a coalition of breast cancer advocacy organizations to promote the WHCRA amendment.
  • Make the case to federal legislators that the WHCRA should be amended to include aesthetic flat closure (aka chest wall reconstruction).
Improved Standard of Care
  • Outreach to the National Accreditation Program for Breast Centers (NAPBC) about their protocol and the case for an amendment to include aesthetic flat closure, ahead of the 2022 ASBRS Meeting.
  • Attend the 2022 ASBRS Meeting and interface directly with breast surgeons and researchers to advocate for an improved standard of care for aesthetic flat closure.
  • Continued consultation and collaboration with all stakeholders to encourage the widespread adoption of an oncoplastic approach to mastectomy. Identify barriers, stakeholders, and steps necessary to achieve this goal.
  • Work together with leading surgeons to integrate AFC technical training into general surgery residency.
  • Grow our new professional tool, the Aesthetic Flat Closure Surgical Photo Database. This tool is a collection of surgical before and after photos filterable by patient body habitus characteristics and surgical/medical parameters. It will serve to facilitate clear communication between patient and provider and help to align expectations, allow patients facing surgery to visualize what they might look like post-operatively, and provide data to support AFC research and surgical training development.
  • Publish and distribute to hospitals and clinics our NEW brochure for medical professionals, a collaboration with @LessThanTwoBreasts (IG), “My Choice: AFC”.
  • Encourage research on insurance coverage denials for flat closure and revision services (and use those statistics – along with the new NCI definition of aesthetic flat closure – to support our case for amending the WHCRA).
  • Support development of standardized oncoplastic training for AFC.
  • Support development of a clinical scoring tool to objectively evaluate aesthetic quality of flat closures.
  • Support development of a new (or amended existing) PRO tool to evaluate patient outcomes after going flat and investigate association with aesthetic quality using the new scoring tool.
Coalition Building & Inroads to Hospitals
  • Work towards the formation of a Young Professionals Advisory Board – in tandem with outreach to medical students and surgical residents.
  • Work to characterize the barriers to parity in each country and determine how NPOAS can maximize the translation of our work in the US to other countries (and vice versa).
  • Grow our Council of International Advocates, to amplify the work of flat advocates worldwide and present a unified message to stakeholders.
Organizational Leadership and Inclusivity
  • Continue to expand our Advisory Council to include at least one: breast surgeon, oncoplastic breast surgeon, general surgeon, oncology social worker, oncology physical therapist.
  • Nominate additional Board members with the explicit goal of ensuring representation of concerns specific to BIPOC and LGBTQ communities.
Medical Coding
  • Support efforts by the American Society of Breast Surgeons (ASBRS) to survey their membership to determine what medical billing codes are currently being used for aesthetic flat closure surgical work.
  • Continue to interface with stakeholders including ASBRS, the American Society of Plastic Surgeons (ASPS), health insurance companies, and others to finalize a mutually agreed upon coding protocol for aesthetic flat closure at initial mastectomy, explant, and revision.
  • Initiate lobbying effort to improve reimbursement by increasing the valuation of the agreed-upon insurance code(s).
  • Continue to provide support to victims electing to pursue legal action.
  • Support professional investigations into the ethical issues surrounding aesthetic flat closure and flat denial, to spark the conversation and encourage development of systems of incentives and accountability in this setting.

Thank You for Your Support…

Let’s go 2022!

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.

One thought on “NPOAS 2022-2023 Two Year Strategic Plan

  1. I feel like plastic surgeons need to more honest with patients like myself that had previous radiation and auto immune diseases with a reoccurrence followed by mastectomies with reconstruction. Everything I have read implants should NEVER be put in a woman with these prior issues. I have suffered for 2 years and 9 months. Explanting to flat 1/12/22, such time, money, my health, and mental anguish wasted for not being told the truth!!’

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