Understanding the Experiences of Women Who Choose to 'Go Flat' After Mastectomy

Recent research highlights that the vast majority of women opting out of breast reconstruction following a mastectomy are satisfied with their decision. Conducted by Flinders University, the study surveyed 460 Australian women who decided to remain flat-chested after either a unilateral or bilateral mastectomy, which entails removing breast tissue due to cancer treatment or preventative measures for those at high risk.

The findings reveal that 92% of participants felt happy with their choice to go flat, an approach often called "flat closure". However, more than 25% reported experiencing unsolicited queries from healthcare professionals regarding reversing their decision or recommending reconstruction even after surgery. Additionally, about one-third sensed a bias from their medical team favoring reconstructive options.

This research was presented at the International Conference on Cancer Nursing (ICCN 2025) in Adelaide, emphasizing the scarcity of data on women’s experiences who choose to remain flat post-mastectomy—a significant gap considering the thousands of women undergoing such procedures annually in Australia.

Dr. Fiona Crawford-Williams from Flinders' Caring Futures Institute emphasizes that informed decision-making is vital. Advocates like Robyn Smith, Melanie Law, and Joanna Atzori are advocating for improved, unbiased resources and support systems that empower women to make choices aligned with their preferences. They call for health care providers to present all options transparently, respecting each woman’s autonomy and decision.

Women choosing to go flat often face societal and medical biases. Researchers criticize instances where patients are questioned critically or subjected to psychological evaluations solely based on their decision to forego reconstruction, which raises concerns about patient rights and dignity.

The collective voices from this study reinforce that women should have the freedom and proper support to choose flat closure without being pressured or judged. Such decisions are deeply personal and benefit from compassionate, unbiased counseling.

Ultimately, enhancing awareness and respect for women’s choices can lead to better patient experiences. As Dr. Crawford-Williams states, "Patients deserve to have their voices heard and their decisions supported without bias." This research advocates for a healthcare environment where all women are fully informed and supported in their post-mastectomy decisions.