Aesthetic Flat Closure: What You Need to Know
A recent study in PRS Global Open shows an increasing trend in women choosing aesthetic flat closure after a mastectomy. This is the decision to remove both breasts and create a truly flat chest wall contour instead of having breast reconstruction. There are many potential reasons someone may make this choice, including the desire:
– to avoid breast implants
– to avoid the additional scarring associated with flap surgery
– to decrease recovery time and time off work
– to minimize the number of surgeries
– to decrease the risk of complications
– to minimize out-of-pocket costs
Regardless of the type of mastectomy being performed, all mastectomies remove the breast tissue. However, many women are unhappy with the way their chest appears after a mastectomy without reconstruction, due to residual skin folds or tissue (known as “dog ears”) that is often left behind by traditional techniques.
Unfortunately, some patients report they were not given the choice to go flat by their surgeons. Others have experienced “flat denial” – this is when “a surgeon’s unilateral actions deny their patient the agreed-upon flat closure, either through negligence or intentional disregard” (NotPuttingonaShirt.org).
Thoroughly discussing your preferences and expectations with your surgical team ahead of time is important to ensure that, if needed, certain surgical techniques are incorporated to provide the best final contour and a true cosmetically-appealing flat result.
Due to the increasing demand for flat closures after mastectomy, there has been a welcomed increase in focus within the plastic surgery community on improving patient outcomes after going flat.
Who is a candidate for aesthetic flat closure?
People in the following situations may wish to consider going flat:
– anyone considering mastectomy because of a breast cancer diagnosis
– anyone considering prophylactic (risk-reducing) surgery because they are at high risk of developing breast cancer
– those who have already had surgery as part of their breast cancer treatment and now wish to be symmetric without reconstruction, with a truly flat chest contour
– anyone who has had breast reconstruction already, is unhappy with their results, and now prefers to go flat instead
Who offers aesthetic flat closure?
Aesthetic flat closure may be performed by a breast cancer surgeon alone or in collaboration with a plastic surgeon colleague.
Many of the techniques used to ensure a flat chest contour are actually plastic surgery techniques (eg V-Y advancement, local tissue rearrangement). Due to the increase in awareness of aesthetic flat closure in the breast cancer community, these techniques are more widely discussed and taught as part of breast surgery training. This will hopefully lead to more surgeons feeling comfortable offering this procedure.
Plastic surgeons are also often asked to perform revision surgery if an aesthetic flat closure was not performed at the time of the mastectomy.
Tips on making a breast surgery choice
When considering aesthetic flat closure, or any other surgical procedure, it’s important to:
– Take the time you need to research all your options using reputable sources.
– Look at before and after photos to help you figure out how you’d like to look.
– Research your surgeon to ensure they routinely perform the procedure you choose.
– Talk extensively with others who have had the surgery you are considering, preferably with the same surgical team.
By asking these questions and taking the time to research your options, you will maximize your chances of having a good outcome that meets your expectations.
Does my insurance cover aesthetic flat closure?
Insurance companies typically cover going flat as part of breast cancer-related or risk-reducing mastectomies. Prior to scheduling surgery, it’s important to speak with your insurance company and make sure your surgical team has confirmed that it will be covered by insurance.
Download our FREE Breast Advocate App to learn more about going flat (aesthetic flat closure).
Free App for Breast Cancer Treatment and Breast Reconstruction Decision-Making
A leader in breast cancer treatment education and shared decision-making, Breast Advocate® is excited to announce the release of our updated free app for breast cancer surgery and breast reconstruction. Thank you to our users for providing the valuable feedback that has helped make our app even better!
The latest updates greatly improve user experience and navigation, and give the innovative breast cancer app a fresh new look. Users can now customize the content they see on their dashboard via a personal feed, and easily find specific content using our optimized search engine.
Co-created by breast cancer specialists and patient advocates, the Breast Advocate® app provides anyone with breast cancer, a history of breast cancer, or at high risk for developing the disease a much needed voice in their treatment decision-making.
Should you have a lumpectomy or mastectomy? Should you have prophylactic surgery? Should you go flat or have breast reconstruction? If you want reconstruction, what type is best for you? Should you have gene testing? Our breast cancer app can help with these questions and much more.
The groundbreaking Breast Advocate® Wizard walks users through a detailed questionnaire to better understand their personal situation, preferences and goals. Our proprietary software combines evidence-based treatment options with the user’s preferences to create customized recommendations that are in line with the user’s specific needs. Breast Advocate® empowers users with the knowledge they need to fully discuss their treatment plan with their medical team and ensure they make the best decisions for them.
Users also have access to the latest expert opinions, published studies, helpful resources, and a community ready to provide support.
Download the latest version of the Breast Advocate app here.
