Your Journey, Your Choice: Breast Reconstruction vs. Going Flat | Warrior Sisters

Breast cancer is a life-altering diagnosis that brings numerous physical and emotional challenges. Among the many decisions women face is whether to undergo breast reconstruction following a mastectomy or to remain flat. Prior to a breast cancer diagnosis most women haven't given this subject much thought.  This decision is deeply personal and influenced by many factors, including psychological effects on body image, self-esteem, and sexuality. Respecting each woman's choice is as important as recognizing this complex issue goes far beyond mere vanity. Both reconstruction or choosing to stay flat come with their own sets of adjustments.

I was 52 when diagnosed with stage 3 Triple Negative Breast Cancer. There was no doubt in my mind that I wanted aggressive treatment with the best odds for a full recovery.  My treatment included a double mastectomy. As the breast surgeon was discussing my surgical options, he included options for reconstruction versus staying flat.  As the words "staying flat" came out of his mouth I had an instant visceral reaction. I was insulted and felt demoralized. I didn't understand why anyone in this modern age would have both of their breast removed and chose to stay flat.  Through this experience I have gained knowledge and understanding about breast reconstruction options. My respect for the diverse and personal choices women make in their journeys has greatly deepened.

The Psychological Impact on Body Image

Body image is a significant part of how we see ourselves and our identity. For many women, their breasts are a big part of their femininity and sense of identity. The loss of one or both breasts can be deeply distressing. For transgender men, choosing to go flat can align their physical appearance more closely with their gender identity, enhancing their sense of self.

 The Role of Reconstruction

Breast reconstruction can help some women regain a sense of normalcy and continuity in their bodies. It can provide a way to restore the appearance of their breasts, helping them feel more like their pre-cancer selves. This can be particularly important in alleviating the shock of body changes and facilitating emotional healing.

Choosing to Stay Flat                                                                                         

Some women choose not to undergo reconstruction. This decision can be empowering, representing acceptance of their post-cancer bodies and a desire to avoid additional surgeries. For these women, staying flat can symbolize strength and a focus on health and well-being. Opting out of reconstruction eliminates the need for further surgical procedures, reducing medical risks and recovery time. 


For women who choose reconstruction, having their breast shape restored can improve their self-esteem by making their body look more like they feel it should. This can be especially helpful in social and intimate situations, making them feel less self-conscious and vulnerable. For women who choose to stay flat, feeling confident comes from accepting and feeling good about their bodies just the way they are. This shows they value themselves for who they are, not just how they look. It can also encourage others to accept different body shapes.


Reconstruction can help women feel more comfortable and confident in intimate situations. The presence of reconstructed breasts can alleviate some anxiety related to body changes, potentially making sexual interactions feel more natural and enjoyable. At first, women who decide to stay flat might find it hard in their close relationships because they worry about how they look and what their partners will think. But over time, many women and their partners learn to understand and enjoy their bodies in new ways. 

Respecting Choices

It's important to know that deciding whether to get breast reconstruction or not is very personal and not just about how it looks. It's about who the person is, how they feel, their health, and their beliefs. Respecting each woman's choice means offering empathy and support, regardless of her decision. Medical professionals, family, and friends should provide information, listen without judgment, and respect our decisions.


The choice between breast reconstruction and staying flat following breast cancer surgery is deeply personal and multifaceted. It involves considerations of body image, self-esteem, and sexuality, all of which are integral to a woman's sense of self. Respecting each woman's decision and providing support through her journey is essential in helping her navigate this challenging time with dignity and empowerment.