Specialized Approaches

After a mastectomy, some women choose not to rebuild the breast with implants or tissue. Instead, they may opt for an aesthetic flat closure. This means the chest is carefully closed and contoured to create a smooth, natural appearance without extra skin folds or excess tissue.

Choosing to “go flat” is just as valid as choosing reconstruction. For many women, it’s the option that feels healthiest, simplest, or most aligned with their personal preferences.

What Is Aesthetic Flat Closure?

An aesthetic flat closure is a type of surgery performed after mastectomy where:

• All breast tissue is removed.

• Extra skin, fat, and tissue are carefully trimmed away.

• The chest wall is contoured to create a smooth, flat surface.

This approach goes beyond simply “removing the breast.” It focuses on clean lines and a natural chest shape, allowing women to wear clothing comfortably and feel at ease with their bodies.

Why Some Women Choose Flat Closure

There are many reasons women choose not to reconstruct after mastectomy:

• Fewer surgeries: Avoids the additional operations often required with implants or flap reconstruction.

• Shorter recovery time: Healing may be quicker since there are no donor sites or expanders.

• Lower medical risks: No risk of implant complications (rupture, capsular contracture) or flap failure.

• Comfort in daily life: Many women feel lighter, more mobile, and more comfortable in their clothing.

• Personal choice: Some women simply prefer a smooth chest and feel empowered in their decision to go flat.

What to Expect From Surgery

• During mastectomy: If you know you want to go flat, your surgeon can perform the closure immediately.

• Contour work: The surgeon will remove extra skin and shape the chest wall for symmetry and balance.

• Scarring: Flat closure leaves scars across the chest where the breasts were removed. These typically fade over time and are placed to minimize visibility under clothing.

• Recovery: Most women spend 1–2 nights in the hospital and return to light activities in 2–3 weeks, depending on individual healing.

Revision for a Better Flat Result

Sometimes, the initial mastectomy does not leave a smooth, flat contour. This may result in:

• Extra folds of skin

• Tissue “dog ears” under the arms

• Asymmetry between sides

In these cases, a flat revision surgery can be done later to refine the chest wall and create the smooth appearance originally intended.

Emotional and Practical Considerations

• Body image: Some women feel a sense of relief and freedom going flat, while others may need time to adjust to their new appearance. Both are normal.

• Clothing: Many women enjoy wearing flat-friendly styles, while others may use external breast forms for certain occasions.

• Community support: Many “flatties,” as some call themselves, find connection and empowerment in support groups and advocacy communities.

Is Aesthetic Flat Closure Right for You?

This option may be a good fit if you:

• Do not want reconstruction surgery.

• Prefer a shorter recovery with fewer long-term risks.

• Feel comfortable with the idea of a smooth chest wall.

• Want to keep future options open (you can still choose reconstruction later, though it may be more limited).

A Personal Choice

“Going flat” is not less than reconstruction—it’s simply a different path toward healing, wholeness, and self-confidence. It’s an empowered decision that honors your choice and prioritizes your health, comfort, and self-image. For some women, flat closure brings peace of mind and a sense of control after cancer treatment.