- Julie Barris | Crisis Counselor | Therapist-in-Training
- Mar 31
Going flat isn't just a physical decision—it can be a statement of self-empowerment, rejecting the pressure to conform to conventional beauty standards.
When faced with a breast cancer diagnosis, the choices can be overwhelming. After undergoing a mastectomy, one of the most challenging decisions for women is whether to opt for reconstruction or to “go flat”—to live without breast reconstruction. The decision is deeply personal, but it can also feel like a battle between societal expectations and individual well-being.
Society's Expectations: What It Means to Be a Woman
For many women, the thought of losing their breasts due to cancer or surgery is not only physical but deeply emotional. Society has long tied femininity and womanhood to physical appearance, especially when it comes to breasts. The image of a woman with breasts is entrenched in culture, media, and social norms, often equating it with attractiveness, youth, and femininity. This pressure can make the decision to "go flat" seem like an impossible one.
Many women opt for a lumpectomy, a surgery that removes the tumor or a part of the breast, because it seems less invasive and doesn’t alter their body as drastically. Others choose breast reconstruction, hoping to retain a more familiar appearance. These options are undoubtedly valid choices, but the emotional weight can be heavy. Women often fear that without reconstruction, they won’t feel like themselves or will lose their sense of femininity.
However, there is an often overlooked path: choosing to go flat. Going flat means rejecting the notion that a woman must have breasts to be considered a woman. For some, it can be a liberating decision, one that allows them to focus on healing, free from the emotional and physical complications that come with reconstruction.
The Dilemma: Beauty, Femininity, and Health
The reality of going flat often brings feelings of loss, but it can also open the door to a different kind of empowerment. For many, the decision to go flat requires confronting internalized expectations about what it means to be a woman.
The pressure to "look like a woman" often stems from a deep-seated cultural narrative about beauty. In a world where female bodies are constantly scrutinized, it can feel like you're losing a part of your identity if you choose a more unconventional post-surgery body. The societal pressure to conform to these standards can create tension for women battling cancer, as they may feel like their value is being defined by how they look, rather than who they are or how strong they are.
Yet, the decision to go flat is not one made lightly. The fear of being perceived as less than, or even "unwomanly," looms large in many survivors' minds. But it's crucial to acknowledge that being a woman isn’t about having a certain body shape or appearance; it's about our stories, our strength, our resilience, and our choices.
The Complications of Reconstruction and Lumpectomy
Opting for a lumpectomy or breast reconstruction can be seen as an attempt to maintain the status quo— to "keep" something familiar, even after the trauma of cancer. However, these procedures come with their own complications. Reconstruction may involve multiple surgeries, infections, and the potential for lifelong medical concerns. For some women, the psychological toll of reconstruction can be just as challenging as the physical effects of cancer.
The decision to choose reconstruction often isn't just about wanting to keep the look of breasts. It may also stem from the desire to avoid stigma or judgment, or to feel "normal" again. Unfortunately, "normal" is often a subjective term influenced by society, not personal comfort. On the other hand, the decision to go flat may feel like the most straightforward path, but it too requires dealing with society’s assumptions and judgments about beauty, worth, and femininity.
Choosing Health Over Societal Expectations
Ultimately, the choice to go flat or to have reconstruction should come down to what feels right for the individual, not societal expectations or external pressures. It's a decision that requires courage, self-acceptance, and a deep understanding that womanhood cannot—and should not—be reduced to the physical.
Going flat can be the healthiest choice, free from the medical complications that might arise from reconstruction, and it can offer the freedom to redefine what it means to feel whole and beautiful. In choosing what’s best for long-term health and peace of mind, the decision is not about being less of a woman—it’s about reclaiming one’s autonomy in the face of a difficult situation.
Redefining Womanhood
We need to start a larger conversation about how we define womanhood in society. Our bodies may change due to surgery, illness, or age, but these changes don’t define who we are as women. True empowerment lies in the freedom to make decisions that are best for our health, happiness, and future without the fear of being judged or feeling less than.
Question for Reflection
As we challenge the norms that dictate beauty and femininity, can we embrace a definition of womanhood that celebrates resilience, strength, and the power of choice—regardless of physical appearance?
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