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NPOAS Vice President, Christy Avila, Passes Away from MBC

By Not Putting on a Shirt / July 21, 2025

NPOAS VP Christy Avila has passed away from MBC.

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Claudia’s Story: Stay Firm With What You Want For Yourself

By Not Putting on a Shirt / February 10, 2025

Claudia was diagnosed with two different types of breast cancer in both breasts at age 51 after her yearly mammogram. She knew she didn’t want reconstruction because she wanted to minimize surgery. She found the NPOAS website and used the resources there to advocate for her choice, finding an excellent surgeon who supported her choice and gave her a great surgical outcome.

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Ruth’s Story: I Have Created a New Identity

By Not Putting on a Shirt / February 3, 2025

Don’t be afraid to challenge expectations and attitudes. Societal attitudes are changing and with greater awareness, being flat is an option.

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Katherine’s Story: I Refuse to Hide What I Have Endured

By Not Putting on a Shirt / January 31, 2025

I refuse to hide what I have endured.
I stand whole and perfect with my scars.
To be honest and valiant. To proclaim the truth.

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Natalie’s Story: Finding My Path Through Mastectomy and Reconstruction

By Not Putting on a Shirt / January 24, 2025

Natalie experienced her mother’s breast cancer diagnosis and treatment, and shortly thereafter was diagnosed with a genetic predisposition to the […]

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Breast Reconstructive Surgeon’s View on Aesthetic Flat Closure Surgery After Mastectomy

By Not Putting on a Shirt / October 30, 2023

Facing Life After Mastectomy Receiving a breast cancer diagnosis is understandably frightening and emotional. In that turmoil of processing such […]

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BCAM Corporate Fundraisers for NPOAS

By Not Putting on a Shirt / September 26, 2022

Enormous thanks to three amazing companies – Total Truck Branding, Crazy Dayz Tattoos, and CRDN – for selecting NPOAS as […]

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New Resource – Sex & Gender Diverse

By Not Putting on a Shirt / May 11, 2022

New resource at NPOAS! Diversity is a beautiful thing… read all about the intersection of sex, gender, mastectomy & AFC […]

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NPOAS 2022-2023 Two Year Strategic Plan

By Not Putting on a Shirt / January 1, 2022

Here’s our detailed aesthetic flat closure advocacy roadmap for the next two years, give or take, broken down by category. […]

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October 13th Metastatic Breast Cancer Awareness Day Metavivor infographic

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

By Not Putting on a Shirt / October 17, 2020

Repost from International FLAT Day Today, October 13th, is Metastatic Breast Cancer Awareness Day. MBC is the only breast cancer […]

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NAPBC reconstructive consult protocol amendment include aesthetic flat closure Not Putting on a Shirt advocacy

New Project! Amend the NAPBC’s Reconstructive Protocol

By Not Putting on a Shirt / March 11, 2020

Women going flat after mastectomy are not getting the care we need and deserve, in part because most of us […]

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Infographic thank you BCBS Vermont revision surgery insurance coverage

Vermont Insurer Blue Cross Blue Shield Supports Revision Bill

By Not Putting on a Shirt / February 26, 2020

Big progress continues in Vermont in ensuring insurance coverage for flat closure and revision services! Representative Charen Fegard’s flat revision […]

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Infographic Vermont DFR revision surgery insurance coverage consumer alert

State of Vermont Moves to Protect Patients

By Not Putting on a Shirt / February 24, 2020

Vermont State Agency Issues Consumer Alert on Revision Denials Big progress is happening right now in Vermont to ensure insurance […]

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consent hand writing in pen transparent sign

Informed Consent is Non-Negotiable

By Not Putting on a Shirt / February 22, 2020

Australian Woman Says Her Surgeon Placed Expanders Without Her Consent ** Update: unfolding information suggests that this situation does not represent […]

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Marie-Claude Belzile - Tout aussi femme Quebec aesthetic flat closure advocate mastectomie a fini plat self portrait with assymetric halter top bralette

Pioneers in Flat Advocacy: Marie-Claude Belzile

By Not Putting on a Shirt / February 7, 2020

Pioneers in Flat Advocacy – A blog series designed to highlight and amplify the voices of the flat advocates whose work built (and continues to build) the foundation for the work that other advocates are doing now.

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Infographic expectation vs reality NCI visuals online Mayo Clinic vs flat denial photos

Clear Language: “Flat Closure”

By Not Putting on a Shirt / February 2, 2020

What does the term “flat closure” mean? Flat closure = chest wall reconstruction post-mastectomy Flat closure is shorthand for surgery […]

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Flat Denial: who is at risk? infographic Not Putting on a Shirt

Flat Denial: Who is Most at Risk?

By Not Putting on a Shirt / February 1, 2020

We’re All at Risk, Right? Our research, presented last year at the San Antonio Breast Cancer Symposium, has identified several […]

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Kim Bowles after mastectomy revision surgery hospital gown #putflatonthemenu Not Putting on a Shirt

Kim’s Revision Surgery After Intentional Flat Denial

By Not Putting on a Shirt / February 1, 2020

I finally decided to get revision surgery, after almost three years living with “a little extra in case you change […]

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Kim Bowles AHN SABCS Review 2019 Pittsburgh exhibitors table #putflatonthemenu Not Putting on a Shirt flat closure research

NPOAS’ Table at the 2019 AHN SABCS Review

By Not Putting on a Shirt / February 1, 2020

A Great Opportunity for Provider Outreach Thanks to Allegheny Health Network and San Antonio Breast Cancer Symposium for putting together the 2019 AHN SABCS […]

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Not Putting on a Shirt Board of Directors announcement infographic 2019

NPOAS Board of Directors

By Not Putting on a Shirt / January 31, 2020

Not Putting on a Shirt is starting 2020 off with a BANG! The new year brings a new crew and […]

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NPOAS AHN SABCS Review announcement aesthetic flat closure research advocacy 2019

NPOAS Exhibit at 2019 Pittsburgh SABCS Review

By Not Putting on a Shirt / January 22, 2020

Not Putting on a Shirt will be exhibiting at the 2019 San Antonio Breast Cancer Symposium Review at the Pittsburgh […]

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Share Your Experience: Revision Surgery

By Not Putting on a Shirt / January 20, 2020

Help us ensure women’s access to care by filling out our short online survey. Your participation in the survey will […]

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Tina flat woman happy selfie topless

Tina – Flat Has Been Freeing

By Not Putting on a Shirt / January 15, 2020

Editor: It’s been some months since we published our last personal story of going flat. Today we hear from Tina […]

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Charen Fegard Vermont state representative headshot

Vermont Rep. Fegard Introduces Revision Bill

By Not Putting on a Shirt / January 12, 2020

Breaking news! Vermont State Representative Charen Fegard has just introduced an historic bill requiring insurance coverage for revision surgery! Charen […]

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Flat closure after mastectomy: Are your patients satisfied with the results SABCS19 poster session Not Putting on a Shirt Kim Bowles speaking to attendees

Our Poster at SABCS 2019

By Not Putting on a Shirt / January 8, 2020

We had a successful poster session at the San Antonio Breast Cancer Symposium (SABCS) this past month, presenting a poster […]

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Coding for Flat Closure thumbnail with picture of paperwork Not Putting on a Shirt

Coding for Flat Closure

By Not Putting on a Shirt / November 25, 2019

Interested in helping us break down barriers that women going flat face when trying to achieve an aesthetic result they […]

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shared decision making steps chart

Shared Decision Making: Protecting Patient Autonomy and Informed Consent

By Not Putting on a Shirt / November 21, 2019

SDM is about patient autonomy and informed consent. Shared decision making (SDM) is a collaborative model of clinical decision-making that […]

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Cleveland Clinic Researchers Publish Paper on Aesthetic Flat Closure

By Not Putting on a Shirt / October 29, 2019

You read that right. Cleveland Clinic researchers, in partnership with the University of Toledo, have been researching flat closure. Cleveland […]

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textured breast implant in gloved hand stock

FDA Issues Landmark Recommendations for Implant Manufacturers

By Not Putting on a Shirt / October 29, 2019

Hot off the press – FDA is listening to women’s voices on breast implants. Today, FDA issued a recommendation to […]

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Not Putting on a Shirt research poster SABCS19 announcement Flat closure after mastectomy: are your patients satisfied with the results?

NPOAS Will Have a Poster Presentation at SABCS 2019

By Not Putting on a Shirt / October 29, 2019

Big news! NPOAS will be presenting a research poster at the San Antonio Breast Cancer Symposium this year, December 10th – 14th. […]

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Christy Avila SF Bay bridge International FLAT Day with teal FLAT sign

Plastic Surgeons Are NOT Required to Discuss Aesthetic Flat Closure

By Not Putting on a Shirt / October 29, 2019

It’s true… plastic surgeons are not required to discuss aesthetic flat closure during the reconstructive consult. Christy Avila of Fierce, Flat, Forward was […]

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Kim Bowles podcast flat denial Not Putting on a Shirt Behind the Pink Ribbon

Behind the Pink Ribbon Podcast with NPOAS Founder Kim Bowles

By Not Putting on a Shirt / October 29, 2019

Now you can listen to NPOAS founder Kim Bowles’ interview with Behind the Pink Ribbon, a new breast cancer podcast by […]

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Midwest Breast & Aesthetic Surgery logo

Midwest Breast & Aesthetic Surgery Publishes Videos on Flat Closure

By Not Putting on a Shirt / October 29, 2019

Flat closure to produce a smooth, breastless chest wall contour is a reconstructive procedure. Listen to Dr. Pankaj Tiwari at Midwest […]

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hand pen drawing the word SURVEY stock

UCLA Researcher Launches Flat Closure Survey

By Not Putting on a Shirt / October 29, 2019

We are so excited to share this news with our community. Dr. Deanna J. Attai, former President of the American Society […]

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October 13th Metastatic Breast Cancer Awareness Day Metavivor infographic

October 13th is Metastatic Breast Cancer Awareness Day

By Not Putting on a Shirt / October 29, 2019

October 13th is Metastatic Breast Cancer Awareness Day. Metastatic breast cancer (MBC) is the only breast cancer that kills, and […]

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flat closure is reconstructive flow diagram breast cancer mastectomy reconstruction choices Not Putting on a Shirt

Flat Closure is Reconstructive, NOT Cosmetic

By Not Putting on a Shirt / October 29, 2019

“Reconstructive” vs “Cosmetic”Surgery In the world of plastic surgery, reconstructive procedures are usually covered by insurance while cosmetic procedures are […]

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International FLAT Day is October 7th!

By Not Putting on a Shirt / October 29, 2019

“International FLAT Day” was created to celebrate going flat – to promote breast reconstruction awareness, to promote flat closure (breastless, […]

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Flat is Where It's At Podcast logo

FLAT Is Where It’s At Interviews Metro Surgical Associates

By Not Putting on a Shirt / October 29, 2019

The FLAT Podcast Stephanie Astalos Jones, who shared her story with NPOAS last year, recently launched her project Flat Is […]

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Flat Friendly Surgeons Directory NPOAS

Now Online – Flat Friendly Surgeons Directory

By Not Putting on a Shirt / October 23, 2019

Your new surgeon is just a click away. Great news for women going flat! Our 150+ strong, international Flat Friendly […]

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New Resource Pages at Flat Closure NOW: Explant and Revision (ARCHIVED)

By Not Putting on a Shirt / January 31, 2019

New Resource Pages at Flat Closure NOW for Patients Seeking Explant and Revision Surgery EXPLANT SURGERY Our sister organization, Flat […]

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Focus on Flat Closure Techniques

By Not Putting on a Shirt / January 20, 2019

Awareness Continues to Spread Word continues to spread among the surgical community that patients going flat after mastectomy expect their […]

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Flat denial is not "oops, I couldn't get it perfect." Flat denial is "your wishes don't matter."

What Flat Denial Is, and Is Not

By Not Putting on a Shirt / December 16, 2018

We would like to clear up any confusion about what flat denial is, and what it is not.  We want […]

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Putting Flat on the Menu: Flat Closure NOW (Archived)

By Not Putting on a Shirt / December 10, 2018

At Not Putting on a Shirt, we are SO excited to announce the official launch of the new collaborative flat advocacy […]

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NPR Interview With Catherine Guthrie

By Not Putting on a Shirt / November 2, 2018

Women’s health journalist Catherine Guthrie, whose groundbreaking article in Cosmopolitan blew the lid off of flat denial, was just featured […]

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NPoaS on the Today Show!

By Not Putting on a Shirt / October 2, 2018

Women’s health journalist and author of “FLAT: Reclaiming my body from breast cancer” Catherine Guthrie and Not Putting on a Shirt […]

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NPOAS Walk to Willard Park 2018 announcement

Register now for the NPoaS Walk on Oct 23rd!

By Not Putting on a Shirt / October 1, 2018

  You can now register here for Not Putting on a Shirt’s Walk on Oct 23rd (Tuesday).  Registration is easy and […]

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