Going flat after unilateral mastectomy

”If we are to translate the silence surrounding breast cancer into language and action against this scourge, then the first step is that women with mastectomies must become visible to each other.”

Audre Lorde, The Cancer Journals
Legendary “Amazons”

Amazons” in Greek mythology were a matriarchal warrior culture in which warrior women amputated their breast in order to enhance their performance with bows in battle.

In the United States, two thirds of mastectomies are unilateral, and are more common in older women and Black women relative to the general patient population. And women who have a unilateral mastectomy actually have reconstruction less often than women who have a bilateral procedure. So there are actually quite a lot of “Amazons” living flat around – presenting both with and without prosthetics.

Making Your Surgical Choice

Amazons, uniboobers, unicorns … no matter what label you use, going flat after unilateral mastectomy can present unique benefits along with unique challenges. The remaining healthy breast can serve for breastfeeding and sexual pleasure, whereas a bilateral procedure largely if not entirely removes those possibilities. And, removal of just one breast can be less of a “shock” to their self-image for some women.

“For me it’s about limiting the impact of cancer in my life… there’s a gray zone between being very proactive about cancer treatment and giving in to overtreatment.”

Katerine, living flat after unilateral mastectomy

Other reasons to choose a unilateral mastectomy include:

  • Less extensive surgery usually means less risk & a shorter recovery period
  • Removing the “healthy” breast does not provide any significant survival benefit or recurrence risk reduction
  • Regular exams of the breast area are still needed for some time after a cancer diagnosis, regardless of whether one breast remains or not (although mammograms or other imaging may be needed for the remaining breast, along with the exam)

Living Flat After Unilateral Mastectomy

Fashion. Clothing can be a bit of a challenge for those living flat after unilateral mastectomy, particularly form-fitting garments and bras. Many Amazons find themselves learning how to sew in order to tailor their clothing to fit their new bodies, and have come up with some amazing tips and tricks! Here are some things to look for:

  • Neckline ruffles
  • Wrap tops with stretchy fabric
  • Layering
  • Cowl necks
  • Thicker/sturdier fabrics
  • Gathering at the shoulders/ruching
  • Button-downs
  • Abstract designs or designs with non-organized stylistic elements
  • Swimsuits with built-in soft foam cups

These aren’t hard and fast rules – every body is different, so do what works for you. Regardless of whether you are going unilateral or bilateral flat, you’ll probably need to do some experimenting with your wardrobe.

“It takes time to redefine the way you want to look; you have to go by trial and error. The main thing isn’t how you look to others. The main thing is how you FEEL.”


Prosthesis. “Living flat” usually means that after your mastectomy with flat closure, you don’t wear prosthetics which are external accessories that are worn under clothing to give the appearance of breasts. But many women who choose flat closure do wear prosthetics, some or all of the time. The only time prosthetics may be medically indicated is if you’re single-breasted and your remaining breast is very large. Prosthetics are mostly an issue of aesthetics – how you want to look, both for your own self-image and confidence and for presenting yourself to the world in a way you feel comfortable with. More about prosthetics here.

Tattoos. Unilateral decorative mastectomy tattoos are an option that help some women feel more positively about their flat side. More about mastectomy tattoos here.

Photo: Roxx Tattoos
Further Reading & Support

“How living with one breast changed the way I feel about my body”

Deciding to Live Out Loud with Only One Breast

Choosing a Breast Prosthesis: A Survivor’s Perspective

One Breasted Beauties (Facebook Group)
Support for women living flat after unilateral mastectomy.
Uniboobers United (Facebook Group)
Support for single breasted women living with or without reconstruction or prosthetics.

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