“Going Flat” After Mastectomy: Patient-Reported Outcomes by Online Survey

Baker, Jennifer L.; Dizon, Don S.; Wenziger, Cachet; Streja, Elani; Thompson, Carlie K; Lee, Minna K.; DiNome, Maggie L.; Attai, Deanna J.

doi:10.1245/s10434-020-09448-9

Cited by 39 publications

(42 citation statements)

References 35 publications

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“…the surgeon did not offer the option to go flat, did not support the decision to go flat, or did not perform the agreed-upon surgical procedure and intentionally left excess skin when the desire to go flat had been expressed. 3 Our research highlights that for a subset of women, 'going flat' is a desired and intentional option, which should be supported by the treatment team and should not imply that women who forgo reconstruction are not concerned with their postoperative appearance.…”

Section: Presentmentioning

confidence: 83%

ASO Author Reflections: Patients Who Go Flat After Mastectomy Deserve an Aesthetic Flat Closure

Baker

Attai

2021

Ann Surg Oncol

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Section: Presentmentioning

confidence: 83%

ASO Author Reflections: Patients Who Go Flat After Mastectomy Deserve an Aesthetic Flat Closure

Baker

Attai

2021

Ann Surg Oncol

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“…A significant fraction of patients will elect to forgo reconstructive surgery and decide to go flat. A recent survey of 931 patients within the growing online going flat communities found that only 74.1% of patients were satisfied with their surgical results [ 11 ]. Dissatisfaction was more likely reported among women with a body mass index (BMI) above 30 kg/m 2 , indicating that aesthetic issues with flaps of excessive skin or subcutaneous tissue might play a major causal role, but this is not scientifically proven yet.…”

Section: Discussionmentioning

confidence: 99%

The double S technique to achieve aesthetic flat closure after conventional mastectomy

et al. 2022

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Background Lateral excess tissue after mastectomy is a frequent problem, which should be included into preoperative planning. Women with lateral tissue abundance are frequently impaired cosmetically and functionally. We suggest a novel oncoplastic mastectomy technique to eliminate the above mentioned. Methods Surgical technique Two small horizontal lines are drawn, one line above and one line below the Nipple Areola Complex. These lines should represent the possible skin excision and allow tight skin closure. Consecutively, two ending points of the incision are planned, one close to the xyphoid area and the other one in the anterior axillary line. These points are then interconnected in an s-shaped manner to form a double s-shaped skin excision. Results The double S-shaped technique is an easy reproducible technique which not only allows good access to the lateral side of the mastectomy, but also and mainly the reduction of lateral fat and skin. Conclusion The double S mastectomy allows for simultaneous removal of access in the axillary region, eliminating skin, and fat as needed and preventing the lateral dog ear

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“…1 Recently, Baker et al surveyed their subset of patients who sought no traditional breast reconstruction following mastectomy, instead opting for “going flat,” and reported that 74% of their survey respondents were happy with their decision. 2 , 3 Interestingly, Baker et al identified that up to 22% of women experienced “flat denial,” which meant that they were not offered the reconstructive option for a flat closure, not supported in their decision to pursue a flat closure, or did not undergo the agreed-upon surgical procedure and were left with excess skin when the desire to go flat was expressed to the surgeon. 2 , 3 However, despite the patient demand for this procedure, there is a paucity of literature on addressing technical aspects of the aesthetic flat closure after mastectomy.…”

Section: Introductionmentioning

confidence: 99%

“… 2 , 3 Interestingly, Baker et al identified that up to 22% of women experienced “flat denial,” which meant that they were not offered the reconstructive option for a flat closure, not supported in their decision to pursue a flat closure, or did not undergo the agreed-upon surgical procedure and were left with excess skin when the desire to go flat was expressed to the surgeon. 2 , 3 However, despite the patient demand for this procedure, there is a paucity of literature on addressing technical aspects of the aesthetic flat closure after mastectomy. 4 To date, there is no plastic surgery literature on specific techniques to achieve an aesthetic flat closure after mastectomy.…”

Section: Introductionmentioning

confidence: 99%

Not Just a Linear Closure: Aesthetic Flat Closure after Mastectomy

Morrison

Karp

2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Currently, there is an increasing trend in women seeking aesthetic flat closure after mastectomy. To date, there is no plastic surgery literature on specific techniques to achieve an aesthetic flat closure after mastectomy. As plastic surgeons, we need to continue to innovate and to iterate new surgical techniques in our reconstructive armamentarium to address the desires of and to optimize the outcomes for our reconstructive breast surgery patients. Herein, we seek to delineate key considerations and employed techniques for reconstructive plastic surgeons performing aesthetic flat closure after mastectomy. Namely, it is crucial to listen to the patient, and to fully understand the patient’s concerns, wishes, and particular aesthetic desired. From a technical perspective, the key surgical pearls include completely obliterating the inframammary fold, ensuring the same size and flap thickness bilaterally, appropriately de-fatting medially on the chest wall to allow for a smooth contour, obviating any presence of dog ears medially or laterally with precise tissue excision, and confirming that the incisions are entirely symmetric bilaterally. Intraoperatively, it is important to sit these patients up to assess soft tissue re-draping, and to confirm that there are no dog ears nor any excess tissue that could compromise the perfectly flat aesthetic chest closure. With the increasing demand for flat closures after mastectomy, plastic surgeons need to be keen on employing modified surgical techniques to best optimize the desired aesthetic flat closure reconstructions for these patients, as these reconstructions are not simply linear closures.

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“Going Flat” After Mastectomy: Patient-Reported Outcomes by Online Survey

Cited by 39 publications

References 35 publications

ASO Author Reflections: Patients Who Go Flat After Mastectomy Deserve an Aesthetic Flat Closure

ASO Author Reflections: Patients Who Go Flat After Mastectomy Deserve an Aesthetic Flat Closure

The double S technique to achieve aesthetic flat closure after conventional mastectomy

Not Just a Linear Closure: Aesthetic Flat Closure after Mastectomy

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