The Problem

Mastectomy patients who asked for a flat result

Going flat after mastectomy is seen and treated as a second-class choice.

Women facing mastectomy are not getting full information about flat closure, and when they do choose to go flat, too often their choice is not respected by their surgeon. They receive an unacceptable surgical result that requires additional surgery to fix – and even then, too often have to fight to have insurance cover revision surgery.



The Solution

Mastectomy patients who asked for a flat result

The path to parity for flat closure has already been blazed by the brave advocates who worked to pass the WHCRA, a 1998 law that requires most insurance companies to cover breast cancer related “breast reconstruction.”

We need:

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List of initiatives here]]]]]]]]]]


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Our Story

Hold Surgeons AccountableKim Bowles, protesting outside of Cleveland Clinic. Her sign reads, “Hold surgeons accountable.” June 29, 2018

Publicly protesting topless is one way to ensure visibility for a problem that until now has been swept under the rug, out of sight, and out of mind. Not anymore – not on Kim’s watch.

“I’ll just leave a little extra in case you change your mind.”

Kim had simply wanted to get back to her life after just one surgery.  But the plastic surgeon she hired to make her flat acted against her clear directive and left excess tissue “in case you change your mind” (his words as Kim was lying helpless on the operating table).  Now, she has to choose whether to live with a cosmetic effect that she finds abhorrent, or to take on additional risk – and sacrifice energy, money, and precious time with her family – just to get a cosmetic result she feels she can live with.

Kim’s results (left) vs. the result she asked for – and her surgeon agreed to (right).

All Kim asked for was an acknowledgment, from the surgeon and hospital, of the wrong that had been done, and a commitment to prevent this from happening to future patients. But her pleas fell deaf ears. So, Kim has chosen to invest herself in helping future mastectomy patients across the US and beyond to receive cosmetic results they choose and can live with following mastectomy.

Against Our Will: “Flat Denial”

What happened to Kim – “flat denial” – is happening to women everywhere. They go into mastectomy expecting a flat result, and wake up to something completely different. Some feel they have no choice but to have more surgery to get an acceptable appearance, which others may not be able to afford. Others still are not well enough for more surgery. They just have to live with the disfigurement that might have been prevented, if their surgeons hadn’t “left a little behind in case you change your mind.”

Of course, most try to ignore it to just get on with their lives. Or worse, the cancer spread, so they need to prioritize the time they have left and focus on survival. Kim fought alone for over a year. Then she started Not Putting on a Shirt.

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