Flat Closure Study Recruiting Women of Color!

Are you a woman of color who chose mastectomy with flat closure?

You may be eligible to participate in this study.

You are invited to participate in a research study titled: “The Pre and Post-mastectomy Experiences of Women Choosing Flat Closure after a Breast Cancer Diagnosis.” Tracy Tyner, a Ph.D. nursing student at Texas Woman’s University, is conducting this study to explore 1) the decision-making experience of choosing mastectomy with flat closure, 2) the experience of being flat, and 3) the experience of viewing oneself in the mirror pre and post-flat closure.

This research will shed light on this understudied population of women, providing a better understanding of what women are experiencing when choosing flat closure. We at NPOAS and the study researchers hope the results will serve as a valuable resource for healthcare providers working with women contemplating or undergoing flat closure.

Up to 40 women will be recruited for this research study.

This is the second round of recruitment and the researchers are specifically looking to enroll women of color so as to include YOUR experiences and perspectives in their research!

Participation Criteria:

The researcher is looking for women 18 years of age or older who were diagnosed with breast cancer (Stage 0 [DCIS] to Stage IV), and “chose” a double mastectomy (removal of both breasts) with flat closure with the intention of remaining flat. Participants must have had their mastectomy with flat closure within the past 3 months to 5 years, had their surgery in the United States, and currently live in the United States. Participants must be able to speak, read, and understand English, and have access to a computer, mobile device, or phone.

Transgender men, women who underwent flat closure after breast reconstruction removal (removal of their implant(s) or breast flap), women who are currently flat but want future breast reconstruction, or women who are flat because they cannot have breast reconstruction are not eligible for this study.

This research study is voluntary. You can choose to participate in the study or not. If you choose to participate, you will be asked to take part in a 60 to 90 minute recorded Zoom or telephone interview about your experience of choosing flat closure and what the experience of going flat has been like for you. Additional meetings may be necessary to clarify interview information and to verify study findings. You will also be asked to share a photo of your flat closure if you wish to do so. Providing a photo is not required for participation. The researcher will use a code name to protect your identity in any future publications. Women completing an interview will receive a $25 Amazon Gift Card. Women completing a study data verification meeting will receive an additional $25 Amazon Gift Card.

The potential total time commitment for this study is 190 minutes. This includes 15 minutes to complete the study consent form, 5 minutes for the demographic survey, 60 to 90 minutes for the interview, a 20 minute meeting to clarify aspects of the interview (if needed), and a 30 to 60 minute meeting for data verification should you be one of the 3 to 5 randomly chosen participants that are asked and are interested in participating in the follow-up meeting.

Inclusion Criteria (you must meet all of these to qualify for the study):

  1. Women 18 years of age or older
  2. Diagnosed with breast cancer (includes Stages 0 [DCIS] to IV)
  3. Choose a mastectomy with flat closure with the intention of remaining flat**
  4. Underwent a double mastectomy
  5. Surgery occurred within the last 3 months to 5 years**
  6. You live in the United States
  7. You had your surgery in the United States
  8. You are able to speak, read, and understand English
  9. You have access to a computer, mobile device, or phone
    **Women undergoing a flat closure revision surgery are eligible to participate

Exclusion Criteria (if you meet any of these, you don’t qualify for the study):

  1. You underwent flat closure after breast implant or breast reconstruction removal
  2. You underwent a mastectomy with flat closure with the intention of having breast
    reconstruction in the future
  3. You underwent a mastectomy with flat closure because you were not a candidate for
    breast reconstruction
  4. You are a transgender male
If you are interested in participating or have questions, please contact Tracy Tyner at ttyner@twu.edu or (972) 855-8450.

NPOAS Partners with Peer Support Group “Fierce, FLAT, Forward”

NPOAS is excited to announce our new partnership with Fierce, FLAT, Forward (FFF), a Facebook peer support group for people living flat or considering going flat after mastectomy for breast cancer, including people explanting to flat. Founded by NPOAS VP Christy Avila, FFF is a thriving, uplifting & welcoming community. Learn more about this amazing resource for patients on the FFF Group Page!

And… FFF team shirts are now available for purchase! All proceeds from shirt sales benefit NPOAS.

#putflatonthemenu

#theflatrevolutionisnow

#fierceflatforward

Where Will You Be FLAT Visible?

Why are some of the ladies taking their shirts off at Stand Tall AFC walks?

1. Because they can.

2. Women are often shamed for being survivors with less than two breasts. Being seen and accepted is the antidote.

BTW, plenty of our flat sisters prefer to keep their shirts on and that is FLATastic, too!

Join a Stand Tall AFC team today at www.StandTallAFC.org!

#iamsage #lessthantwobreasts #aestheticflatclosure #bodypositive #mastectomy

Flat Closure Study Now Recruiting Participants!

Did you choose mastectomy with flat closure?

You may be eligible to participate in this study.

You are invited to participate in a research study titled: “The Pre and Post-mastectomy Experiences of Women Choosing Flat Closure after a Breast Cancer Diagnosis.” Tracy Tyner, a Ph.D. nursing student at Texas Woman’s University, is conducting this study to explore 1) the decision-making experience of choosing mastectomy with flat closure, 2) the experience of being flat, and 3) the experience of viewing oneself in the mirror pre and post-flat closure.

This research will shed light on this understudied population of women, providing a better understanding of what women are experiencing when choosing flat closure. We at NPOAS and the study researchers hope the results will serve as a valuable resource for healthcare providers working with women contemplating or undergoing flat closure.

Up to 40 women will be recruited for this research study.

Participation Criteria:

The researcher is looking for women 18 years of age or older who were diagnosed with breast cancer (Stage 0 [DCIS] to Stage IV), and “chose” a double mastectomy (removal of both breasts) with flat closure with the intention of remaining flat. Participants must have had their mastectomy with flat closure within the past 3 months to 5 years, had their surgery in the United States, and currently live in the United States. Participants must be able to speak, read, and understand English, and have access to a computer, mobile device, or phone.

Transgender men, women who underwent flat closure after breast reconstruction removal (removal of their implant(s) or breast flap), women who are currently flat but want future breast reconstruction, or women who are flat because they cannot have breast reconstruction are not eligible for this study.

This research study is voluntary. You can choose to participate in the study or not. If you choose to participate, you will be asked to take part in a 60 to 90 minute recorded Zoom or telephone interview about your experience of choosing flat closure and what the experience of going flat has been like for you. Additional meetings may be necessary to clarify interview information and to verify study findings. You will also be asked to share a photo of your flat closure if you wish to do so. Providing a photo is not required for participation. The researcher will use a code name to protect your identity in any future publications. Women completing an interview will receive a $25 Amazon Gift Card. Women completing a study data verification meeting will receive an additional $25 Amazon Gift Card.

The potential total time commitment for this study is 190 minutes. This includes 15 minutes to complete the study consent form, 5 minutes for the demographic survey, 60 to 90 minutes for the interview, a 20 minute meeting to clarify aspects of the interview (if needed), and a 30 to 60 minute meeting for data verification should you be one of the 3 to 5 randomly chosen participants that are asked and are interested in participating in the follow-up meeting.

Inclusion Criteria (you must meet all of these to qualify for the study):

  1. Women 18 years of age or older
  2. Diagnosed with breast cancer (includes Stages 0 [DCIS] to IV)
  3. Choose a mastectomy with flat closure with the intention of remaining flat**
  4. Underwent a double mastectomy
  5. Surgery occurred within the last 3 months to 5 years**
  6. You live in the United States
  7. You had your surgery in the United States
  8. You are able to speak, read, and understand English
  9. You have access to a computer, mobile device, or phone
    **Women undergoing a flat closure revision surgery are eligible to participate

Exclusion Criteria (if you meet any of these, you don’t qualify for the study):

  1. You underwent flat closure after breast implant or breast reconstruction removal
  2. You underwent a mastectomy with flat closure with the intention of having breast
    reconstruction in the future
  3. You underwent a mastectomy with flat closure because you were not a candidate for
    breast reconstruction
  4. You are a transgender male
If you are interested in participating or have questions, please contact Tracy Tyner at ttyner@twu.edu or (972) 855-8450.

Stand Tall with Us This October to Normalize AFC!

NPOAS has partnered with breakout flat visibility campaign Stand Tall AFC for its 2022 campaign… and beyond! Stand Tall AFC is a campaign to de-stigmatize the loss of breasts to cancer treatment and to normalize aesthetic flat closure.

Breast cancer awareness events brings thousands of people together. Stand Tall AFC teams of flat survivors and supporters utilize these events as platforms for visibility to promote going flat as a healthy choice and to inspire body positivity. We have 23 teams in 18 different states so far, and we are growing fast.

Join a team or start your own today at StandTallAFC.org!

Your 2022 Campaign Support Team includes Renee Ridgeley (LessThanTwoBreasts), Stacey Sigman (Flat Retreat Community), Kimberly Bowles (NPOAS), Christy Avila (NPOAS, Fierce Flat Forward, International FLAT Day), Tesha Sheraton and Elizabeth Hotaling.

You can also donate to support the campaign here, and follow Stand Tall AFC on Facebook and Instagram.

AFC Info at BreastCancer.org!

Breastcancer.org is the premier online educational resource for breast cancer, with information about risk, diagnosis, treatments, surgical options, survivorship and more. We are so happy to announce that as of today, that information includes aesthetic flat closure!

Many people think of reconstructive surgery as breast reconstruction with tissue flaps or implants. But aesthetic flat closure — considered to be the gold standard for going flat — is also a form of reconstructive surgery.”

This is a huge step forward for patients facing mastectomy. Many patients have additional questions after their surgical consults and turn to online resources like BreastCancer.org. Having aesthetic flat closure information included on the site will empower patients who choose to go flat with clear language to communicate their wishes and advocate for the best possible surgical outcome. And it will reach many patients BEFORE their surgeries!

Way to #putflatonthemenu, BreastCancer.org! The gold standard indeed!

Book Launch for “Flat & Happy” This Thursday


Join us for a virtual book launch event this Thursday, June 9th at 8pm ET!

>>Join Zoom Meeting<<

Topic: Flat & Happy Virtual Book Launch
Time: Jun 9, 2022 08:00 PM Eastern Time (US and Canada)

Join Zoom Meeting
https://us06web.zoom.us/j/87586872177?pwd=WUF6VXR6akhXU0F3bzExbTR3V1NoUT09

Meeting ID: 875 8687 2177
Passcode: 160524


Order Your Copy Today!

“The weeks leading up to mastectomy surgery or the removal of an implant are often filled with scary statistics and bewildering medical jargon. For a woman navigating this tumultuous time, Flat and Happy is like a conversation with a good friend who’s been there and done all the research: informative, personal and brimming with humor and heart. Written in consultation with experienced breast cancer specialists, this comprehensive guide is hailed as a “unique and invaluable resource for any woman faced with a diagnosis of breast cancer.” Flat and Happy gives women who are seeking an alternative to breast reconstruction the information and tools they need to make informed decisions and to advocate for themselves before and after surgery.”

Flat & Happy – Book Description, Amazon.com

#womensupportingwomen

#putflatonthemenu

#aestheticflatclosure

#mybodymychoice

#mastectomy

Update on NPOAS Oncology Nursing Conference Exhibit

NPOAS represented FLAT the last week of April 2022 at the Oncology Nursing Society ‘s 2022 Congress! Huge thanks to lead volunteer Renee Ridgeley (@LessThanTwoBreasts & the voice of Dr. Wendy Sage, the first openly single breasted TV character) for organizing and staffing our exhibit, and to all of our volunteers who staffed the booth. Here’s a report from Renee!

Not Putting On A Shirt took aesthetic flat closure (AFC) awareness and education to the Oncology Nurses Society (ONC) 2022 conference. Following their success at the American Society of Breast Surgeons (ASBrS) conference earlier this year, NPOAS was encouraged by ASBrS attendees to have a presence at ONS where over 2,600 oncology nurses, patient navigators and other medical providers gathered for the in-person conference in Anaheim, California, April 28 to May 1. 

Six breast cancer patient advocates and one patient caregiver volunteered to work at the NPOAS booth which was located in the nonprofit Advocates corridor of Exhibitors Hall. These seven women engaged over 300 medical professionals over the course of three days. Conference attendees engaging with the NPOAS booth were able to:

  • learn about NPOAS’s work with breast and plastic surgeons to ensure optimal surgical outcomes for women who choose to go flat after mastectomy
  • view testimonial videos of patients who chose AFC
  • talk with advocates who shared their experiences
  • submit their practice for the NPOAS Surgeons Directory for AFC and Goldilocks mastectomy
  • register their breast clinics to receive My Choice AFC educational brochures for patient distribution (offered free of charge in English and Spanish by NPOAS)

NPOAS advocates distributed over 300 NPOAS brochures (with information and links to the NPOAS website) and over 400 My Choice AFC educational brochures (a literary supplement to a patient’s surgical consultation). Several nurses and navigators requested 20-30 patient brochures for immediate use at their clinics. NPOAS continues to ship orders from attendees of both American Society of Breast Surgeons and ONS conferences.

Many nurses who had experienced breast cancer themselves shared personal stories of breast cancer surgery with the NPOAS advocates. Nurses with implants, tissue-based reconstruction and flat closure were candid about their experiences. Several nurses with reconstruction reported decision regret due to lack of information about collateral damage of reconstruction. Other nurses reported that AFC would be their choice if ever faced with a breast cancer diagnosis.

A few patient/nurses reported being shamed by surgeons for choosing not to reconstruct breast mounds. One young nurse, in her 20s at the time, went against her doctor’s wishes and demanded that her expanders be removed permanently, and that she be closed flat after being admitted to the hospital for life-threatening infections. Another oncology nurse in her 30s was repeatedly questioned for choosing not to reconstruct. In the hospital just before mastectomy, her surgeon again challenged her decision to go flat “with an eyeball roll”, then warned her that she would have long scars. The woman (of average BMI with B-cup native breasts) woke from anesthesia to find her incisions extended from the top of her biceps through the axilla, across her chest and then down to her waist. The nurse reported that this was not an optimal outcome.

Nurses and patient navigators shared with advocates their enthusiasm for AFC awareness, with many noting their practice was supportive and competent in providing AFC. Some attendees expressed frustration with the lack of institutional patient education material available for women choosing flat. Some nurses reported that the surgeons they work with do not support flat and actively dissuade women from their option to go flat. Many took NPOAS and My Choice AFC brochures back to these surgeons.

These stories as well as the warm reception from all the attendees who engaged with the NPOAS booth, were confirmation of the important and necessary work provided by NPOAS.

NY AFC Bill Passes in Senate!

This Just In… NY Bill has PASSED in the Senate!

As of May 31st, the New York AFC bill has passed in the Senate, and should be signed into law by the governor later this year! Women in New York State will no longer have to fight their insurance companies to get coverage for their AFC (Aesthetic Flat Closure) surgeries.

Huge thanks to Senator Toby Ann Stavisky for sponsoring the bill, to Representative Stacey Pheffer Amato for her leadership in the Assembly, to all the members of the NY Congress who voted in support of the bill, to the American Society of Plastic Surgeons (ASPS) for their support, and to all the many folks who worked tirelessly over the past seven months to get this done!

How was this accomplished?

Based on connections made in Flat Retreat Community in October of 2021, advocates including Jo Amato , Melissa Eppard, Christy Avila and Kimberly Bowles joined forces with Assemblywoman Stacey Pheffer Amato to compose an amendment to NY state law to rectify a loophole which allowed insurance companies to deny coverage for AFC services. Thanks to the hard work and dedication of the bill’s sponsors in the Assembly, their staff, advocates and volunteers from NY state, the bill passed unopposed in both houses. As of May 31, 2022, the bill is on its way to the governor’s desk to be signed into law.

What does it mean?

When the bill is signed into law, it will ensure that insurance companies cannot deny coverage for AFC surgeries, including a plastic surgeon at the initial mastectomy, as well as subsequent revision surgeries, in New York State. The bill also serves as a template for amending the federal law (WHCRA, Women’s Health & Cancer Rights Act) which will not only protect patients nationwide, but will also be foundational to an improved standard of care for women going flat. 

Learn more about the bill at NotPuttingonaShirt.org/NYBill