Kourtnii’s Story: I Struggled to Get the Flat Surgery I Chose

Kourtnii was faced with a DCIS diagnosis at the age of 26. She wanted a double mastectomy without reconstruction but repeatedly received intense, paternalistic pushback from the surgeons she consulted. Ultimately she had to have two separate mastectomy surgeries and didn’t get the aesthetic outcome she wanted. She does not regret her decision to stay flat.

I was 26 when breast cancer entered my life. I was prepared, though. After having family members with their own breast cancer stories, I had already decided I had wanted a double mastectomy. I didn’t even realize at the time that my surgeons wouldn’t listen to my wishes and instead choose to follow their own agenda.

In 2019, I found a lump in the bath and it felt big. I had just started seeing someone and I called him in to show him. The next day I went to the doctors and it was only weeks before we had answers. A biopsy on April Fools’ Day came back positive for high grade DCIS. The next few weeks were a blur of appointments. Surgeons kept pushing me to have a lumpectomy and “save my breasts” but this lump was 3.5cm – it would take most of my breast. I asked a few times for a double mastectomy. The surgeons refused! They told me to think about my new relationship and told me that having a double mastectomy would affect my relationship and that my partner could leave me.

I asked a few times for a double mastectomy. The surgeons refused!

I continued to push. I had a meeting a week before surgery where the nurse told me the surgeon now recommended a mastectomy because of the size of the tumor. I told her great, let’s do that. Could you take both breasts in the same surgery? Again I was told no. The next week I saw the surgeon for the final consultation before surgery. I should have walked away then. He asked me what I had decided, and I replied, “Well, after our meeting with the nurse last week I have decided to go with your recommendation of a single mastectomy. I really do want a double mastectomy though.”

“Mastectomy?!? I never recommended that for 9mm of DCIS.”

My partner and I both stare at the surgeon. “Doctor, my DCIS has never been measured at 9mm, it’s last measurement was 35mm.” The surgeon then continued on and said well then what will we do for reconstruction? Will I get the nurses to place you on the waitlist for expanders to implants? I told him no, I really wanted some time to think about that decision.

My mastectomy went off without a hitch, the surgeon boasted about how beautiful my incision was, and continued to ask about what reconstruction I wanted. He kept on telling me how his beautiful incision would be hidden perfectly by my new reconstructed breasts. He seemed angry when I asked to be sent to another hospital for a second opinion. After weeks of back and forth I was finally placed on the waitlist to have my other breast removed. I waited 10 months for my next surgery, and after consulting with a bigger hospital flat was just a step in the process to let my body heal.

He seemed angry when I asked to be sent to another hospital for a second opinion.

I went in for my second single mastectomy. I remember seeing the surgeon and telling him please make my scars match. He confirmed that he would. In the operating room, a young female surgeon came in and asked about what’s being done. I pull my gown open and told her, “We’re taking the other breast. See my scar? Please make the new one match.”

Surgery happened late in the afternoon. The next morning they came to check on me. The young female surgeon comes in smiling and perky. “So everything went pretty well. You had a bleed but we put that pressure dressing on to stop it. Your incision is beautiful and straight!”

Straight?! I thought I had asked for my scars to match. The young surgeon walked out. Only minutes later the main male surgeon arrived, ripped open the pressure dressing to reveal an almost perfectly straight incision on my chest. I burst into tears. The surgeon sid something about plastics being able to fix it and walked out, leaving my dressing half ripped off.

After that experience I decided that flat was the only option for me. I didn’t want breast implants and was concerned about BII and other compilations associated with breast implants. My new plastic surgeon has been super supportive of my decision to stay flat which has changed everything for me.

And that person I was seeing? They haven’t gone anywhere. They are my biggest supporter in my decision to opt of reconstruction surgery. So the surgeon was wrong about that too.

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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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