Charen’s Story: Authenticity & Health


Charen, a legislator in New England, made an informed choice to go flat after her prophylactic bilateral mastectomy for BRCA-1. She prioritized her health and function as well as having a short surgery and recovery period. Her surgeon respected her wishes. Two weeks after surgery, Charen was back to hiking and living her life!


Due to family and personal health history, I was diagnosed with the BRCA-1 gene mutation in 2016. When I knew my path was prophylactic mastectomy, I met with my surgeon. She insisted I listen to all the options, which included going flat, implant reconstruction, or DIEP flap reconstruction. After asking questions related to health, function and recovery, I chose to go flat for the following reasons.

  • I could have my mastectomy and ovary removal all in one OR session instead of enduring additional risk of infection or injury from anesthesia.
  • I was outpatient instead of spending 1+ days in ICU.
  • I needed a small fraction of the pain management.
  • My recovery time was 1/4 to 1/3 as long.
  • I maintained full use of my arms and shoulders instead of having my pectoral muscle or abdominal tissue mutilated.
  • Reconstruction could not give me back what I lost. Implant reconstruction looks like a war injury and they are cold and numb. DIEP Flap leaves huge scars on the abdomen for numb, scarred “mounds”.
  • I am not ashamed of losing my breasts, nor do I need to make people believe that I have breasts in order to have professional or personal relationships built on respect, trust and common goals.

I was very lucky. I had an excellent breast surgeon who explained everything to me clearly, respected my wishes, and who had the skill to give me an aesthetic flat closure in one procedure. It healed quickly and well. Two weeks later I was on a gentle hike and a month after that, I was on a wilderness canoe trip. Going flat allowed me to have a life built on authenticity and health. It was the best choice for me to achieve personal and professional goals from outdoor or farming activities to better advocating for mastectomy patients in the state legislature.

And honestly, nobody has ever noticed unless I brought the topic up.

It is crucial for the dignity of mastectomy patients that they are fully informed of the medical choices and risks and that their wishes for an aesthetic flat closure be respected and fully carried out.


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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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