Make it A Double: My Decision to Go Flat After Breast Cancer

There are women all over the world advocating for flat closure and starting nonprofits to put flat on the menu and make it a viable choice when it comes to mastectomy.

It was the summer of 2015. I turned 40 that summer and became a “flattie” just days after my milestone birthday. At that time, I was still fairly new to breast cancer and had no idea what to expect.

I met with the surgeon for the first time and I can still remember our conversation about my size and not having enough skin to reconstruct so he said he could use skin from other parts of my body. I am a smaller person and always have been. I had friends tell me I should gain weight. But gaining weight was not going to help anything; it wouldn’t create extra skin.

Turns out my oncologist was the one running the show, and not the surgeon. And because I was metastatic, he did not want me to have reconstruction. His concern was we wouldn’t be able to see my recurrences as well if I did get reconstructive surgery.

The surgical oncologist and the oncologist had come to an agreement, mastectomy without reconstruction.

If I was going to have a mastectomy without reconstruction, I wanted both breasts removed, which I was told was OK at the beginning of the process. But, about a week before surgery I was told they would be only doing a unilateral mastectomy. In my mind, I felt that I would be much happier with both breasts removed even though I was told this wouldn’t increase my survival.

For symmetry and the hopes that I wouldn’t have to go through any other surgeries, this was my choice.I had to do a little bit of letter writing and cajoling, but it was decided I could have a double mastectomy.I was unknowingly advocating for myself and learning to speak up. So, back to the surgeon to figure this all out.

I was a little nervous at first because the surgeon was younger than me and I didn't even know him. I told him (OK, more like pleaded with him), “Just make my scars flat, even and straight. Please just make it look nice.”

Little did I know at the time, there are surgeons out there who leave extra skin, called a skin sparing mastectomy, just in case. Imagine waking up like that. I’ve seen pictures and it’s not pretty. I was one of the lucky ones. My young surgeon did exactly as I asked, aesthetic flat closure, even before aesthetic flat closure was considered a reconstructive option.

Now, five years later, there are women all over the world advocating for flat closure and starting nonprofits to put flat on the menu and make it a viable choice when it comes to mastectomy. A few of these organizations are Flat Closure Now, Not Putting on a Shirt, Flat Retreat, Flatties Unite, and so many more.

Some of these women even hosted a ball, which I attended, and it happened to be the last normal event pre-COVID 19. These women make me proud to be a “flattie.” What an inspiring night that was to be surrounded by so many who had been through the going flat process and still look and feel beautiful.

If I had to do it all over again, I would still go flat, and make it a double.