Many mastectomy patients opt for breast reconstruction or go flat after surgery and they are happy with their choices.

Around 75 percent of women surveyed said no to breast reconstruction after their mastectomy, and they were satisfied with the results.

But around 25 percent said their doctors did not support their decision on going flat, says the study. This study was published by the journal Annals of Surgical Oncology on January 3, 2021.

Dr. Deanna J. Attai, associate clinical professor at UCLA David Geffen School of Medicine stated that “For patients, the findings may serve to reinforce their decision and may provide some degree of support knowing that there are others who are making the same choice that they are.”

“The findings may also help patients better communicate with their surgeons regarding their surgical choice.”

About the Research on Breast Reconstruction

Dr. Deanna Attai explained that “There were several studies published showing that women who did not have reconstruction had poorer quality of life compared with those who underwent some form of post-mastectomy reconstruction.” 

“I was seeing an increasing number of women in the online communities openly discussing their ‘going flat’ experience, as well as seeing more online support and advocacy organizations for these women,” Dr.Attai reported.

She further added, “However, I was interacting with women in the online community, and there are a growing number of ‘going flat’ patients and advocacy groups.”

“These women and organizations were providing information and support and seemed very comfortable with their decisions,” she said.

 “So it seemed like there was a disconnect between what I was seeing in the surgical literature and what I was exposed to in the online communities. We wanted to specifically reach out to the patients in the online communities to assess their experiences.”  

In this study, researchers examined 931 women aged 49 years who underwent a bilateral mastectomy (both breasts) or unilateral (one breast). They either treat breast cancer or decrease high breast cancer risk. All women who finished the online test did not have a breast mound reconstruction. In the study, women used a five-point scale to evaluate their satisfaction with the surgical results and the support from their physician/surgeon throughout the process.

The researchers found that the tool generally used to measure the quality of life and satisfaction with surgery results is called BREAST-Q. Dr. Attai and her colleagues surveyed these women recommend creating a new study tool to ask about satisfaction with no reconstruction and factors related to happiness.

This survey helped scientists find concerns unique to women who decided not to undergo reconstruction, which was not observed by other survey tools.

73.7% of women want to proceed with mastectomy in the study.

Dr. Attai stated, “While our respondent population may not be representative of the ‘average’ patient, it’s still a large number of women who were happy with their results.” 

65.2% of women reported that they got adequate information about their surgical options before they want to make decisions about reconstruction. 20.7% of patients said that their surgeon did not provide ample support to their decision to go flat.

Dr. Attai further added, “(‘Flat denial’) is a term I learned from the patients, and it includes not initially being offered the option to go flat, being discouraged (by their surgeon) from going flat, or the surgeon not performing the agreed-upon procedure — intentionally leaving excess skin and later stating it was done in case the patient changed her mind about reconstruction (and that the excess skin could be used for a subsequent procedure.”


Women stated that the primary reasons for undergoing a mastectomy are avoiding placing a foreign object in their bodies and recovering faster than if they also had reconstruction. As a result, the satisfaction score after a mastectomy in this survey was 3.72 out of 5.