Going Flat

I had an interesting conversation today with a dear patient. Its a common conversation, but nonetheless, it is always interesting to me. Every patient has a different view on the subject of this conversation. Every patient has a different relationship with the subject of this conversation. Society and social pressure has a huge impact on the subject.

What is the subject of this common, yet intriguing, conversation?

Going flat vs. breast reconstruction.

"Going flat" is now a common saying for a simple mastectomy, in which the breast tissue is removed completely either to treat a breast cancer or prophylactically to reduce the risk of cancer in a woman who carries a genetic mutation, like BRCA1 or 2. In this operation, once the breast is removed, the skin is closed over the chest wall and its flat. Hence, going flat.

Reconstruction is just what it sounds like: the breast is reconstructed, and there are a many techniques and types of reconstruction. Some reconstructed breasts look completely natural; others, not so much. Some women love their reconstructed breasts, some tell me that they have come to regret their choice to have reconstruction.

No one "wants" to make this decision, but once we get past that hurdle and face the decision head on, I have never been able to predict which patients would chose going flat versus reconstruction. It doesn't follow socioeconomics or age, it doesn't follow marital status or sexual orientation, and it certainly doesn't follow society's conventional ideas of beauty. Its a tough one.

All of this is to say, that today I recalled an amazing article in the New York Times that has stuck with me since I came across it at the end of 2016. And I want to share it with whomever is reading this.

Here is the original piece,

"Going Flat after Breast Cancer"

and the follow up about the photography of these survivors,

"The Women Who Showed Their Breast Cancer Scars"

Hopefully, you haven't used up your free articles on NYTimes.com this month (and if you have, you should really consider getting a subscription, because how do you live without the NYTimes.com for the rest of month?)

I don't have any answers, and I've asked myself a few hundred times the exact same question with no definitive answer. But, its always an interesting conversation.

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