Flat Denial: My Surgeon Ignored My Choice — Here’s What Happened

S3E21
Choosing to go flat after breast cancer surgery should be a valid, respected option — but for many women, it isn’t.

In this episode of Besties with Breasties, Sarah and Beth are joined by Kim Bowles, founder of Not Putting On a Shirt, to talk about aesthetic flat closure and why so many women are denied the outcome they explicitly request. Kim shares her personal experience of choosing to go flat, waking up from surgery to find her choice ignored, and the additional trauma and surgeries that followed.

The conversation breaks down what aesthetic flat closure actually means, why surgeons sometimes leave excess tissue without consent, how often this happens, and why lack of accountability remains a systemic problem. Kim also explains the insurance, coding, and access barriers women face — and what patients can do to advocate for themselves before surgery.

This episode is essential listening for anyone considering mastectomy, reconstruction, or going flat — and for anyone who believes patient consent should be honored.

In This Episode, We Discuss:
What aesthetic flat closure is and why it matters
Why many surgeons deny flat closure without consent
The difference between flat, concave, and suboptimal outcomes
How often women are intentionally left with excess tissue
Why surgeons assume patients will “change their mind”
Insurance and coding myths around flat closure
The physical and emotional impact of revision surgeries
How Not Putting On a Shirt advocates for patient rights
Questions patients should ask before mastectomy surgery

About Besties with Breasties & Faith Through Fire
Faith Through Fire is a 501c3 Non-Profit. Our mission is to reduce the fear and anxiety that breast cancer patients feel and replace it with hope and a path toward thriving. We do this through peer mentorship, which can be implemented nationwide. We host educational supports in-person and virtually to help overcome the trauma of breast cancer.

Learn more or become a supporter at faiththroughfire.org
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If this episode helped you better understand your surgical rights or empowered you to advocate for your body, please like, subscribe, and share it with someone who may need this information.