New Resource! Aesthetic Flat Closure Photo Gallery

Looking for flat closure photos? Visit our Photo Gallery page to view all kinds of aesthetic flat closure images – initial mastectomy, revision and explant, flat denial, and mastectomy tattoos. Includes a lifestyle section with links to the many flat and body positive personal and professional projects available on social media!

This resource will assist patients and providers in the shared decision making process by providing a variety of images to facilitate a mutual understanding of the patient’s expectations. We add images to the Gallery on a regular basis. You can submit your flat closure photos here.

Survivornet: “To Reconstruct or Not”

Read SurvivorNet’s Sonya Collins’ new article “To Reconstruct or Not: After Mastectomy, Two Women Take Very Different Paths

“Kathy Reed always knew that if she ever had to have a mastectomy, she would not have breast reconstruction. She would live flat. She knew this long before she was diagnosed with breast cancer at age 44 in 2003.”

Sonya Collins for SurvivorNet

Kathy’s surgeon, despite her confidence in her decision, left “a little extra in case you change your mind.” Sounds familiar: this is intentional flat denial. Kathy decided against additional surgery and has lived with the results of her initial surgery for over fifteen years.

“When she asked the surgeon why he hadn’t taken that tissue, ‘He said, “I left those because it’ll make it easier if you change your mind later and decide you want reconstruction. It’ll look smoother,”‘ she recalls him saying.

“… Reed never went back to have the tissue removed. ‘That would have been an extra surgery, which is exactly what I was trying to avoid.’ And now, 16 years later, she occasionally wakes from dreams where she has breasts, but she never wishes she had them in real life.”

Kathy’s surgery, where she was intentionally denied a flat closure, happened long before we had the term “aesthetic flat closure” on the books. Now, thanks to the National Cancer Institute, women can ask for the term by name to ensure their expectations are made clear and to provide a mechanism for accountability. From the article (our links):

“In fact, up to one in ten women who clearly ask to go flat are left with unnecessary and unsightly tissue.  The patient-advocacy organization ‘Not Putting on a Shirt’ advises women to ask specifically for “an aesthetic flat closure as defined by the National Cancer Institute.” Women may also show their surgeon pictures of flat-living women whose shape and scars they find acceptable. These pictures can be found at and”

Thank you SurvivorNet for highlighting Kathy’s story, and for mentioning Not Putting on a Shirt so women can access the information, tools and resources they need to advocate for their choice: aesthetic flat closure.

Read the whole article here.

#flatdenial #mybodymychoice #putflatonthemenu #aesthetic flat closure #notputtingonashirt

Mind Bloom Podcast: NPOAS’ Devorah Vester on Going Flat (Aesthetic Flat Closure)

Executive NPOAS team member Devorah Vester spoke Mind Bloom host Marina Gee about her cancer experience and going flat, informed consent, and what sourdough baking can teach us about how to weather life’s challenges. Episode 24: “Not Putting on a Shirt, with Devorah Vester” is available on Google Podcasts or wherever you get your podcasts!

Tune in to the Mind Bloom podcast every Tuesday for more great interviews and discussions about the intersection of mental health and breast cancer awareness.


New Resource! “Living Flat”

For women who have recently gone flat and are adjusting to their new bodies, we now have a resource page up that covers how to find community support, flat fashion, body image & sexuality (including 20 or so body-positive flat visibility projects), prosthetics, mastectomy tattoos, a collection of articles and videos about going flat, words of wisdom from women who have been there, and more!

Check it out at

If you would like to suggest a resource or topic for the Living Flat page, please send us an email at!


Breast Cancer United: Walk With Us This Nov. 27th

Big news! NPOAS has joined Breast Cancer United, a movement garnering the collective strength of over 50 leading breast cancer organizations, on a mission to eradicate breast cancer. We have joined forces, uniting as one to show the world that breast cancer exists far beyond pink ribbon campaigns and the month of October.

Register today to join Breast Cancer United’s virtual walk this Nov 27th, Black Friday, to build Breast Cancer awareness, empower our community, and demand action. Breast cancer is the most common cancer in women in both developed and developing economies. In the U.S., it is estimated that in 2020, 276,480 new cases of invasive breast cancer will be diagnosed in women and about 1,620 new cases of breast cancer will be diagnosed in men.  Research recently published in JAMA shows that a significant amount of breast cancer screening are being missed and that cases are going undetected due to the ongoing COVID-19 pandemic. The Black Friday virtual walk on Nov 27th will help reignite the importance of early detection, self-examinations, screening, and stage IV research.

Don’t forget to sign up / Get your shirt! Note: the deadline for shirt orders is Monday 11/9 at midnight, for delivery before the event.

#breastcancer #breastcancerunited #bcu #endglobalbreastcancer #Allyship #GSD #ifnotnowwhenifnotuswho #fightlikeagirl #radicaldisruption #unitedwestand #blackfridaytakeover #unitedwewin

Going Flat Story Featured in Florida Local Newspaper

Aesthetic flat closure in the news! AmySue Benker of Naples, FL tells her story, including how she decided to go flat. Read HERE. AmySue said of her decision:

“’I don’t want anything foreign in my body,’ she said… Benker’s other reasons for going flat included less chance of recurrence; increased job responsibilities as the executive director at North Naples Church; the chance to feel normal; and a realization that ;I didn’t need them.'”

In the article, AmySue’s breast surgeon, oncoplastic specialist Dr. Sharla Gayle Patterson MD (who is also on our Directory), is quoted as saying:

“‘I’ve seen a shift in the last 18 to 24 months,’ she said. ‘We’ve been so focused on reconstruction. Save the tatas. Some women want a flat, friendly aesthetic closure. That’s why it’s so important to listen.'”

Dr. Sharla Gayle Patterson MD
Photo: Alex Driehaus

Way to get the word out, AmySue! Thanks to the NewsPress, reporter Craig Handel, and photographer Alex Driehaus for this article!




Juliet Fitzpatrick in Vogue UK

Vogue UK just published Juliet Fitzpatrick’s story! Read HERE. Three other survivor’s stories are also featured, including Rime Hadri who went flat after her unilateral mastectomy. Photos are from a London-based photography project called “Behind the Scars” by Sophie Mayanne, which celebrates scars of all shapes and sizes, and the incredible stories behind them, encouraging people to celebrate the skin they’re in.

Photo: Sophie Mayanne

“I have completely accepted my scars, they’re part of me. They show the trauma I’ve gone through and I’ve come out of the other side as a stronger and more beautiful woman — both inside and out.”

Juliet FitzPatrick (UK)

When asked what we should be doing for breast cancer awareness, Juliet replied:

“More should be done to raise awareness of secondary breast cancer. It’s a hard message to communicate. People don’t want to hear it, but it’s an important subject.”

We couldn’t agree more. “Secondary breast cancer” is also known as metastatic breast cancer (MBC), and about one in three women who are diagnosed with early stage will progress to MBC and die from the disease. To support MBC research for better treatments to extend life and for a cure, you can donate to organizations like the Dr. Susan Love Foundation, the Breast Cancer Research Foundation, and Metavivor.

We appreciate Juliet’s tireless work promoting flat visibility and MBC awareness across the UK and beyond!




Carine (France) Speaks Out About Fighting to Go Flat

Via Pascale Contrino of Complètement FEMME – l’audace d’être entière après une mastectomie (and a member of our Council of International Advocates)

Published in Rose Up Magazine, October 14, 2020

From France, Carine speaks out about her choice to explant with aesthetic flat closure (“reconstruction à plat,” or “fermeture esthétique à plat”). After her diagnosis in her 40’s, she had to fight for her CPM (contralateral prophylactic mastectomy, or removal of the other, “healthy” breast) and was not offered the option to go flat. Her initial implant reconstruction was extremely uncomfortable, and after nine months she found Marie-Claude Belzile‘s work at Tout aussi femme and felt empowered to have one last surgery: explant to flat.

Photo:  PEJ :: design | photography for Rose Up Magazine

“Relief: I have finally managed to express to my surgeon my wish that no more woman has to undergo the humiliation of having to be considered destroyed after the removal of one or both of her breasts.

Disappointment: I can measure all the work to be done so that this choice of a ‘flat reconstruction’ is integrated into consultation protocols and onco-surgical practices.”

Carine for Rose Up Magazine

Read the whole article here.





Mollie Hartford: This Breast Cancer Awareness Month, think beyond pink

Mollie in MA wrote this incredible article about the need to focus on our resources on metastatic breast cancer research for better treatments and a cure, and also threw this in for good measure:

“Plus, not everyone chooses reconstruction. Ask me about “aesthetic flat closure” or “going flat” (and how it’s a struggle to get doctors to believe it’s what we really want).”

Mollie Hartford for the Daily Hampshire Gazette




October 13th is Metastatic Breast Cancer (MBC) Awareness Day

Repost from International FLAT Day

Today, October 13th, is Metastatic Breast Cancer Awareness Day. MBC is the only breast cancer that kills. Ten percent of new BC diagnoses are “de novo” metastatic, and about 1 in 3 early stage diagnoses will progress to MBC.

Marissa Holzer (USA) wrote this article for CURE magazine to highlight #aestheticflatclosure, #InternationalFLATDay and #MBCAwarenessDay.

Not only am I living with metastatic breast cancer, but I am also a Flattie. What doesn’t seem to get the attention it deserves in October, besides aesthetic flat closure, is metastatic breast cancer. One in eight women will be diagnosed with breast cancer and one in three of those women will become metastatic. Twenty-two percent of those with metastatic breast cancer will live five years past their diagnosis. I am part of that twenty-two percent.

Marissa Holzer for Cure magazine

You can support MBC research by donating to organizations like METAvivor Research and Support Inc. which fund critically important research into treatments and work towards a cure, including #theMBCProject.