Fiona’s Story: I Instantly Knew I Would Stay Flat


Even though Fiona knew immediately that she wanted to stay flat after her mastectomy, she met with pushback at every turn.  Her surgeon required that she have a psychological consultation before agreeing to remove her “healthy” breast. She was treated as “less than” because of her decision to go flat. She was not given an aesthetic flat closure and still struggles with acceptance, using art to process her feelings.


I live in the UK, where I had my first mastectomy in 2014, aged 46. I was told I would not be able to have immediate reconstruction because I would need radiotherapy. That was fine by me – I instantly knew I would stay flat. My second mastectomy was elective, and took place in 2016. I had to have a session with a psychologist before the surgeon agreed, because it involved removing healthy tissue. I was really angry about this – had I wanted reconstruction, I could have gone straight ahead with surgery, no mental health checks needed, even if I went for extensive surgery to remove healthy tissue from elsewhere to use in the reconstruction. I felt that my choice to go flat put me right on the outer limits of acceptability. Every time I saw a nurse of doctor, that choice was questioned, and I was told countless times that I might change my mind. I knew I wouldn’t. Anyway, the second mastectomy didn’t go so well. I got a huge, breast-sized hematoma. I was told it would probably go down over the next few years. The reactions from the medical staff implied that I didn’t deserve any help to rectify this.

I felt that my choice to go flat put me right on the outer limits of acceptability.

I have no regrets about not going for reconstruction. I do have regrets that I didn’t know how to ask for aesthetic flat closure, or convey to the surgeons that I was totally certain aI have no regrets about not going for reconstruction. I do have regrets that I didn’t know how to convey to the surgeons that I was totally certain about my decision not to reconstruct, now or in the future. Looking at your website brings tears to my eyes, even 5 years on, knowing that I have a very visible hematoma mound on one side, uneven, ugly, scars, and big bulges under both my arms.’

The day before my first surgery I took photos of my right breast. The day before the second mastectomy I memorialised my one remaining breast by painting it and pressing against paper to make a print. I have put these on a website I’ve started, where I begin to explore my emotions around this, and how it makes me feel so closely connected to my mum who also had a mastectomy. The site is here: https://www.palimpsest.space/

I’m grateful to Not Putting on a Shirt for your advocacy work, and hope things will change so that women’s decisions and preferences are better respected in future, and others are able to get the flat closure they want. Thank you for your initiative.


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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.

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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