Our Impact

Infographic - social media banner for #notputtingonashirt - pictured: Flat Friendly Surgeons Directory, Protect Your Choice brochures, mission, and core values
What have we accomplished since our inception in the Summer of 2018? Quite a bit, we’re happy to report. To support more work like this, share us on social media, donate, or volunteer!

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Putting FLAT on the Menu

An introduction to who we are and what we do at Not Putting on a Shirt.

Original Research Poster at #SABCS19

At the close of 2019, less than two years after her first protest, our President Kimberly Bowles flew to San Antonio, Texas to present NPOAS’ research poster at the world’s premier breast cancer research conference – the research yielded important information to inform patients and providers about the prevalence of flat denial and how to direct future research efforts. It was received positively and was highly effective in engaging attending surgeons and researchers on the topic of aesthetic flat closure.

#SABCS19 poster ID P6-11-23 Flat closure after mastectomy: are your patients satisfied with the results? #notputtingonashirt

Flat Friendly Surgeons Directory

Infographic - Flat Friendly Surgeons Directory #notputtingonashirt #aestheticflatclosure

As of November 2022, we have over 450 surgeons on the Directory recommended for flat closure at initial mastectomy, explant, and revision. The listings are searchable and are cross-referenced with the popular explant lists online. The Directory is a critical tool for patients, both as a stopgap to empower women to protect their choice in the absence of a reliable standard of care for aesthetic flat closure, and as a tool to organize and recognize leading medical professionals who work tirelessly to provide women with surgical results.

New York State Legislation: Chapter 571

NPOAS worked with legislators in New York State to pass an historic bill ensuring insurance coverage for aesthetic flat closure services.

What’s in the NEW LAW? New York State law contains a word for word copy of the federal Women’s Health & Cancer Rights Act (WHCRA) which requires most insurance companies to cover the costs of breast reconstruction. Wherever the law formerly mentioned “breast reconstruction”, NY Law Chapter 571 (formerly Bill A8537 (Pheffer Amato) / S7881 (Stavisky)) now reads “breast or chest wall reconstruction.” It’s that simple! The law also mentions aesthetic flat closure as defined by the National Cancer Institute as specifically included in “chest wall reconstruction.” This ensures that patients are not denied necessary care simply because they chose to forgo breast reconstruction in favor of a flat closure.

My Choice: AFC Brochures

In 2022, we shipped over 4,000 My Choice: AFC brochures globally to advocates as well as over 60 breast care clinics, free of charge thanks to the generosity of our donors.

This full color, illustrated trifold brochure gives an overview of what aesthetic flat closure is and has a QR code which links to nonprofit educational and peer support resources for your patients.

Stand Tall AFC: Flat Visibility Campaign

Stand Tall AFC is a campaign to de-stigmatize the loss of one or both breasts to cancer by promoting aesthetic flat closure (AFC) and body positivity at public events.

In 2022, over 700 participants on 40 plus teams walked in breast cancer awareness events to promote flat visibility around the globe!

OPBC Includes “Optimal Flat Closure” in Mission Statement

#notputtingonashirt infographic - announcing OPBC added "optimal flat closure" to their mission #aestheticflatclosure #putflatonthemenu

In an important step forward, in April 2020, the Oncoplastic Breast Consortium (OPBC) added “optimal flat closure” to its mission statement, recognizing flat closure as an oncoplastic procedure deserving of an aesthetic surgical approach. NPOAS first reached out to OPBC in February 2020 by joining the organization’s patient advocacy group and entering into discussions about potential mission overlap. We discovered very quickly that OPBC and NPOAS share the same goal – to see oncoplasty become routine in breast cancer care by means of advocacy, research, and promotion of improved, evidence-based standards of care. We were overwhelmed with gratitude when OPBC amended its mission statement to be inclusive of aesthetic flat closure. And we look forward to continuing working with them to promote oncoplastic breast surgery worldwide!

NCI Adds “Aesthetic Flat Closure” to Dictionary

In June 2020, the National Cancer Institute (NCI) added “aesthetic flat closure” to its Dictionary of Cancer Terms, defined as “A type of surgery that is done to rebuild the shape of the chest wall after one or both breasts are removed…” and also describes what the procedure generally entails – removal of excess tissue and contouring to produce a smooth, flat chest wall.

#notputtingonashirt infographic - thank you National Cancer Institute for working to #putflatonthemenu by defining #aestheticflatclosure in the NCI Dictionary of Cancer Terms

When NPOAS reached out to NCI in January 2020, we had no idea that they’d generate change this quickly. This is a great example of our organization’s approach to getting the job done – one step at a time, reaching out to all possible stakeholders and making the case to each of them in a clear and effective manner. For the NCI Dictionary folks, clear language is their job. They recognized a glaring deficit: there was no term describing this procedure. We made this case plainly to NCI, and were bowled over with their positive and supportive response.

Awareness Video: Aesthetic Flat Closure

NPOAS worked with our advisors Drs. Tiwari and Kocak to produce an awareness video to empower women going flat after mastectomy with clear language to advocate for their choice: aesthetic flat closure. The video reached over 4,000 viewers on Facebook alone within a month’s time.

Provider Resources on Flat Closure

#notputtingonashirt screenshot of Provider Resources page including statistics on flat closure and data from #SABCS19 poster

NPOAS has developed extensive resources for providers interested in flat closure. Our Provider Resources page includes:

Your generous donation enables us to continue our work to ensure that aesthetic flat closure is given the same respect and consideration as conventional reconstructive options. Help us #putflatonthemenu – show your support today!

To support more work like this, share us on social media, donate, or volunteer!