A Huge WIN for Patient Education!
Groundbreaking News! Absolutely stellar news from flat advocates Robyn Towt (GPAC) and Andrea Citarelli Ottaiano (Silver Lining Holistic Health)! These amazing women worked with the National Comprehensive Cancer Network (NCCN) on the 2022 updates of the breast cancer patient guidelines to include flat closure as an explicit, valid reconstructive choice. Way to put FLAT on the menu, ladies!
About NCCN. NCCN’s mission statement: “The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of 32 leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so all patients can live better lives.” NCCN Guidelines are used by clinicians and patients as a reference for best practices and comprehensive patient educational resources. Visit the NCCN Guidelines for Patients page to see the new editions!
“Flat Closure
In a total mastectomy with a flat closure, the entire breast, including nipple, extra skin, fat, and other tissue in the breast area are removed. The remaining skin is tightened and sewn together. No breast mound is created and no implant is added. The scar will be slightly raised and differ in color than the surrounding skin. A flat closure is not completely flat or smooth. The end result varies from person to person. Ask to look at “after” pictures from flat closures so you know what to expect.
You might decide to have a flat closure procedure at a later time or after having breast implants removed. Talk to your care team to learn more.”
NCCN Guidelines for Patients – 2022 Breast Cancer Guidelines


About the Advocates. Robyn and Andrea became advocates after multiple breast cancer diagnoses and explanting their initial implant reconstruction due to systemic symptoms (breast implant illness (BII) ). They work tirelessly to spread awareness about both the risks of breast implants and the option of going flat after mastectomy as a healthy, beautiful alternative to breast mound reconstruction.

