The true reason behind the ‘flat chest’ trend: Women turn back on breast reconstruction post cancer

There is an emerging collective of Aussie women who are proudly embracing their status as “flatties” – after overcoming the unimaginable.

Alice Colgrave has gone from wearing a 10dd bra to being completely flat-chested, after being diagnosed with breast cancer at 48 and having a mastectomy. Picture: Keryn Stevens

There is an emerging collective of Aussie women who are proudly embracing their status as “flatties”, opting against reconstructive surgery after having a mastectomy.

New research reveals more than 90 per cent of women who choose to “go flat” after having one or both breasts are happy with their decision.

But they want more information on surgical options available for women when they undergo a mastectomy for cancer or preventative reasons, including flat closure.

Data collected as part of a two-year research project reveals less than two in five women felt they were made aware of all possible choices ahead of their breast removal surgery.

And a quarter of those who opted to “go flat” didn’t not feel supported in their decision to do so by their healthcare team with 28 per cent saying their choice was questioned after surgery.

Research lead Fiona Crawford-Williams, part of the Cancer Survivorship Program at Flinders’ Caring Futures Institute, said the topic lacked investigation.

“Thousands of Australian women undergo a mastectomy in Australia each year but there has been very little research into the experiences of those who choose to go flat ... a well-informed person can’t make the wrong decision,” she said.

Robyn Smith (left) is a BCRA gene mutation carrier and co-founder of Flat Life Australia who chose to ’go flat’ after her preventative double mastectomy, she is pictured with Dr Fiona Crawford-William. Picture: Annika Dean,

Dr Crawford-Williams surveyed 460 women ranging in age from 30 through to 80 who had decided to “live flat” after a single or double mastectomy as part of her research.

Some of the common reasons given was to speed up recovery and avoid additional surgeries.

“Women spoke of ... needing to get back to work and not wanting that longer recovery time,” she said.

“Others, particularly older women who’d had children, done their breastfeeding, felt as though their breasts had served them well but they didn’t define them as a woman.”

Dr Crawford-Williams said many women shared they didn’t feel supported in their decision, or found it hard to get information on non-reconstruction options.

“They had to keep sort of advocating for themselves ... 92 percent felt they were happy with the choice to stay flat but didn’t want to keep getting asked if they would consider a reconstruction later.”

Robyn Smith is comfortable with her decision to ‘go flat;. Picture: Annika Dean

Alice Colgrave wants women facing a mastectomy to be given all surgical options, including flat closure. Picture: Keryn Stevens

Alice Colgrave with the youngest of her children, and only son, Stanley, 12. Picture: Keryn Stevens

Two years ago Robyn Smith, a carrier of the BCRA gene mutation who underwent a preventative masectomy in 2019 aged 39, co-founded Flat Life Australia, an online community that has already swelled to almost 1000 to support those who opted against breast reconstruction.

“There seemed to be a lot of information and support for people who were reconstructing but very little awareness of (flat-chested outcomes), so a couple of us ‘flatties’ got together ... we share experiences, good and bad,” she said.

Adelaide mum-of-six Alice Colegrave chose to “go flat” after having a breast removed due to a cancer diagnosis in 2018.

“Everything happens so quickly ... it would be really good if all women who are diagnosed are provided with information about aesthetic flat closures, as well as reconstruction; women know themselves enough to be able to make a decision,” she said.

Originally published as The true reason behind the ‘flat chest’ trend: Women turn back on breast reconstruction post cancer