Aesthetic flat closure is a surgical procedure commonly performed after a mastectomy for patients who choose to remain flat instead of opting for breast reconstruction. The surgery is also a method of gender-affirming care for transgender men. It works by removing breast tissue and then tightening and smoothing the remaining tissues and excess skin to create a flat chest wall contour. Aesthetic flat closure is considered the best surgical method for going flat and can be performed at the time of mastectomy or a few months later. It’s an increasingly popular choice for women who’ve undergone a mastectomy, as it allows for a quicker recovery and offers other lifestyle benefits.
Benefits of an Aesthetic Flat Closure Post Mastectomy
There’s no wrong choice when it comes to deciding what’s best for you post-mastectomy. That said, choosing to undergo a flat closure following your mastectomy is a valid, healthy, and beautiful option that offers many benefits, including:
Aesthetics – A mastectomy with additional chest wall contouring achieves a clean, symmetrical look. When you work with an experienced reconstructive breast surgeon, scarring is minimal at the incision closure, and patients are typically very satisfied with the results.
Empowerment – Many patients who undergo an aesthetic flat closure procedure feel empowered by their choice to reject stereotypical standards of beauty and embrace their flat chest as a symbol of what they’ve overcome.
Practicality – Aesthetic flat closure surgery reduces the need for ongoing medical or cosmetic procedures, making it a practical and low-maintenance choice.
Recovery time – An aesthetic flat closure after a mastectomy typically requires 3–4 weeks of recovery time, compared to 6–8 weeks of recovery required for a breast reconstruction. Going flat also lowers your risk of complications and discomfort. After enduring months or years of breast cancer treatment, some women are eager to return to their lives as soon as possible after undergoing a mastectomy, making flat closure a compelling option.
Lifestyle – Some women rejoice in not needing to wear a bra and having the freedom to exercise and perform day-to-day activities without feeling weighed down by their breasts.
Health benefits – Flat closure decreases the risk of back pain, promotes good posture, and allows for better balance due to the removal of chest weight.
Types of Mastectomy Surgical Incisions
Different types of surgical incisions can be made to achieve different results. Your surgeon will work with you to determine where your scars will lie based on your preferences and medical needs. Here are a few variations:
Curved – Curved scars offer a more natural appearance because they align with the initial shape of the breast and may result in a flatter chest contour.
Straight – Straight scars are a standard choice, as they look neat across the body. You may be able to decide if they lie horizontally, diagonally, or vertically based on your personal preference.
Placement – Choosing to place your scars high or low mostly depends on your fashion and lifestyle habits. A lower placement allows you to wear low-cut tops without revealing your scars, while a higher or middle placement allows you to show off a scar-free midriff. Consider also if your lifestyle is conducive to one type of placement over another. For example, if you’re a frequent hiker, your backpack buckle may cut across the top of your chest and rub uncomfortably on your scar if it’s placed high.
Anchor vs. Y-shaped – Patients with larger breasts may require tissue rearrangement to achieve a flat appearance free of “dog ears,” which are bunched-up sections of skin and tissue that typically form under your arms. In this case, you may require an extra incision, which can create either an anchor or a Y-shaped scar pattern.
Joined – If you desire a smoother central chest contour, your surgeon may recommend connecting the two incisions, creating a single, elongated scar extending across the chest.
Separate – Separate scars are standard, as they mimic the placement.
How to Achieve an Aesthetic Flat Closure
Although aesthetic flat closure is cosmetically significant, it’s first and foremost a reconstructive procedure designed to improve your overall health. It’s important that your surgeon honors your choice to be breast-free and is capable of executing a surgery that both fulfills the medical necessity and yields an aesthetically satisfying result. Be specific that you want an aesthetic flat closure that creates a flat chest contour without excess sagging skin. Some surgeons have been known to go against patients’ wishes, leaving excess tissue in case they change their minds about wanting traditional breast mound reconstruction.
Your flat closure surgeon should be experienced, patient, and willing to provide answers to questions you may have about your procedure. He or she will walk you through what to expect and be attentive to your desired outcomes to achieve the ideal surgical result. Remember, a flat closure procedure will impact your appearance for the rest of your life, so it’s important to research your surgeon’s qualifications and ensure that you feel comfortable working with them and confident in their ability to provide your desired outcome. If you’re looking for a specific incision type, see if you can work with a surgeon who specializes in the type of closure you desire.
Questions to Ask Your Flat Closure Surgeon
Here are a few questions to consider asking your surgeons:
- Can the mastectomy and flat closure be completed in one surgery?
- Will my aesthetic flat closure procedure require a plastic surgeon?
- Are the surgeons experienced in performing this procedure?
- Can you provide pictures of previous surgical outcomes?
- How will the surgeons avoid “dog ears?”
- What type of incision will the surgeons use and why? How far back will the incision extend?
- Will the breast area look flat when I’m in both a sitting and a reclining position?
- Are there any special considerations based on my body type and medical needs?
Finding the Right Aesthetic Flat Closure Surgeon in the Midwest
Many of our patients report feeling a renewed sense of self, leading to greater health, happiness, and confidence as they embark on their flat-closure journey. Our experienced aesthetic flat closure surgeons in Ohio and the Midwest will support your choice to go flat and help you achieve your desired results.
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