
Not Putting on a Shirt is a 501(c)(3) organization advocating for optimal surgical outcomes for women who choose to go flat after mastectomy.
Our Mission
Our mission is to advocate for satisfactory aesthetic outcomes – as agreed upon by the mastectomy patient and surgeon(s) – for those who choose to go flat. We inform and support patients, demand increased accountability for medical professionals and institutions, and collaborate with patients and the surgeons who care for them to establish resources and protocols that will make a difference.
Our Core Values

Clear Language
Aesthetic flat closure is reconstruction of the chest wall contour.
Flat denial is when a surgeon disregards the patient’s consent and fails to perform the agreed upon aesthetic flat closure.

Full Disclosure
Women must be given full and accurate information about ALL of their reconstructive options, including aesthetic flat closure.

Shared Decision Making
The decision making process must center the patient’s values and priorities from start to finish for optimal surgical outcomes.

Evidence-Based Medicine
An optimal, evidence-based standard of care must be developed for aesthetic flat closure in order to ensure women consistently receive acceptable surgical outcomes.

Accountability
Respect for women’s informed consent is non-negotiable. Surgeons who intentionally disregard a woman’s reconstructive choice must be held accountable.

Fair Reimbursement
Surgeons deserve to be fairly reimbursed for flat closure and revision services, as aesthetic flat closure is a truly reconstructive, NOT cosmetic, procedure.

Systemic Parity
Achieving parity for flat closure requires legislative and regulatory change. Both the NCI [UPDATE! NCI has defined “aesthetic flat closure” as reconstructive (“rebuilding” the chest wall contour)] and WHCRA’s definitions of “breast reconstruction” as well as the NAPBC’s reconstructive consult protocol must all be amended to explicitly include aesthetic flat closure.
Our Work
Learn more about our initiatives.
What People Saying About Our Mission
“[Doctors] should respect a patient’s wishes and not think they can make a decision which impacts the way a person sees themselves.”
Nita Noons Shaw, Fabulously Flat (Unreconstructed Breast Cancer Survivors)
“After suffering an amputation or worse (sometimes double amputation, sometimes cancer), a woman should not be left purposefully maimed. “
Kimberly Pantel, NPOAS supporter
“Everyone deserves to feel comfortable and confident in there own body! [N]o one else has the right to make a choice of what you should want your body to look like!“
Anna Lee Lorenzen , NPOAS supporter
Find out more!

REGISTERED CHARITY ID# 84-3021062
FAIR USE STATEMENT
This site contains copyrighted material. Not Putting on a Shirt’s educational materials and resources on this site are freely available for “fair use” (Title 17 U.S.C. Section 107) in accordance with our mission to advocate for optimal outcomes for those who choose to go flat after mastectomy. The copyrighted material on this site is distributed for educational purposes without profit – all donations to Not Putting on a Shirt directly fund our advocacy work. If you wish to use copyrighted material from this site for purposes that go beyond “fair use”, you must first obtain explicit permission from the copyright owner. Please direct requests or questions to info@notputtingonashirt.org.