Lifesaving Scars: Double Mastectomy and Aesthetic Flat Closure

When I looked down to see my chest for the first time, it was beautiful.

• Procedures: double mastectomy, aesthetic flat closure
• Reconstruction immediately postmastectomy: no
• Year of procedures: 2024
• Age: 34 years old
• Race or ethnicity: white

Join the free BC community!

Connect with thousands of members and find support through daily live chats, curated resources, and one-to-one messaging.

Sign up

My diagnosis to treatment

In April 2023, I found a lump in my left breast and called my gynecologist. I was in the living room with my husband and four kids when I saw the biopsy results uploaded in MyChart. I searched “basal white carcinoma” online and gasped — every post said cancer. I didn’t get a call from my doctor until the next day, and he told me it was invasive and aggressive breast cancer.

At the time, I had more questions than you can imagine. The survival rate was the first thing that popped into my head. He saw me the next morning, even though it was a Saturday, and told me we’d figure out a plan.

I wanted to tell everyone immediately. I knew we’d need help taking care of our kids. We have two sons with autism on opposite sides of the spectrum. My husband asked, “How much does one person have to go through?”

When I called my sister to tell her the news, she was already driving over from states away.

Choosing aesthetic flat closure

During my chemotherapy treatments, I met with scheduled plastic surgeons, and they all mentioned a skin-sparing mastectomy with expanders and implants because I wasn’t a candidate for DIEP flap reconstruction. But none of these options felt right for me.

I met a sweet lady who shared why she went flat on Instagram, and it really opened my eyes. She wrote that she’d been through so much chemo that she didn’t want to go through more surgeries. She wanted as much skin gone as possible.

I thought, you know what? Me too. I’m a young mom of four. I’m also BRCA1-positive with triple-negative breast cancer. I wanted as much skin from the area removed as possible.

I posted about my options in a Facebook support group called Fierce, Flat, Forward and met the most compassionate women. They said, “How can your doctor not tell you about flat aesthetic closure just because you’re young?”

It’s sad. If you’re young, they want you to have breasts. But if you’re 70, they might say it doesn’t matter, you’re not sexy anymore.

My husband was a little spooked when I told him I wanted aesthetic flat closure. I said, “If I’m being completely honest, I love you, but I don’t care what you think. I want to be here as long as possible.”

I knew that breast reconstruction wouldn’t increase my risk of recurrence, but I’d heard about cancer recurring behind a woman’s implant where she couldn’t feel it and catch it early.

I told my breast surgical oncologist I wanted aesthetic flat closure, and that was that.

Treatment complications

I was treated locally with four types of chemotherapy, and it went well until my 13th round of chemo. I went to the hospital with a fever so high I could barely move or speak. I tested positive for the flu, so they gave me Tamiflu.

But my health kept declining over the next 2 months, and I lost 30 pounds. My blood pressure would spike and drop all the time, even when I was sitting on the couch. I visited a cardiologist, who said my heart was perfectly healthy.

If I had more than one bite of food, I’d throw up. My doctor kept telling me these were side effects of chemo.

My mastectomy was scheduled at MD Anderson, and the doctors told me I needed to eat 60 to 80 grams of protein per day to be strong enough for surgery. I tried to chug protein drinks, but my body rejected them. In the back of my mind, I truly thought I was dying. I worked in a nursing home for years, and that’s what I saw happen.

When I left my kids before my mastectomy, I sobbed. I was terrified because I knew I hadn’t had enough protein, and my heart was still racing.

At MD Anderson, the doctor said my heart rate was really high but that they’d still do the surgery if I wanted — until they received my blood work. My cortisol levels were nonexistent because chemo had damaged my pituitary gland. They said if they were to put me to sleep, I wouldn’t wake up.

I met with an endocrinologist who said I’d be on steroids for the rest of my life, and they made all my symptoms go away. One month later, I walked into MD Anderson with my breasts for the last time.

My double mastectomy experience

My surgical team wheeled me into the operating room, and I was already loopy. An anesthesiologist placed a mask over my nose and mouth and told me to take deep breaths. Before I knew it, I was in the recovery room.

When I came to, I felt compression on my chest, and my breasts were gone. I thought, “I’m alive! I did it!” That night, the nurse took off my bandages to check my incisions, and I saw my chest for the first time.

It was beautiful. I saw two perfect, lifesaving scars. My surgeon did a great job, and I’m flatter than I’ve ever been. It takes getting used to because I can feel my ribs instead of breast tissue. But I am beyond happy with my results and couldn’t imagine having gone a different route.

What I want others to know

My biggest advice is to educate yourself. Don’t just listen to what the doctors tell you. Reach out to women who’ve been through breast cancer and find out why different women chose to go flat.

Every breast cancer support group that I’ve found has been incredible. They call it a sisterhood for a reason — we’ll support you without judgment, no matter what decisions you make.

Many women choose expanders and implants for their mental health. Seeing your chest without breasts can put some people into depression.

Going flat gave me peace of mind to know that if I have a recurrence, I’ve done everything in my power to prevent it.

Educate yourself and reach out to this community. You’ll learn more and get more honest answers from the community than you will from doctors.