I have many women who find my page while searching for answers after a recent breast cancer diagnosis. Trying to learn their options and find solace as they struggle to decide what’s best for them when faced with a mastectomy. To reconstruct or not? For me, I knew I wanted to return to my normal baseline as quick as possible after being diagnosed with breast cancer. Aesthetic Flat Closure (AFC) allowed me to continue in my normal state of comfort and embrace my body without further surgeries or complications. After learning about the risks of reconstruction—like multiple surgeries, infections, emotional stress, and years taken away from you—I knew AFC was the right choice for me.
AFC offered freedom from ongoing procedures while helping me to feel confident while knowing I put the health of my body first. There is no denying that AFC is the healthiest option for a woman’s body to recover from, however many surgeons do not even present the option to women. Whether you choose to reconstruct or to go flat, it is a personal decision for each woman. Whatever choice is made, the decision should be an educated one, not just one that is guided. Which is why I created this blog to help others evaluate the pros and cons more efficiently and honestly.
It’s about being comfortable with your body and making the choice that feels best for you. 💖
Reconstruction is a valid choice for many, but it’s important to understand all your options. Whether you choose AFC, reconstruction, or something else, it’s about embracing your journey and making informed decisions on your own terms. This question isn’t just about appearance—it’s about comfort, health, emotional well-being, and ultimately, the way you want to move forward. I hope this helps you evaluate both options from a place of truth, peace, and empowerment.
What is Aesthetic Flat Closure (AFC)?
Aesthetic Flat Closure is a surgical option for women who decide not to pursue breast reconstruction after a mastectomy. Instead of creating new breast mounds, the surgeon carefully removes excess tissue and smooths the chest wall for a clean, flat, and aesthetically intentional appearance. It’s not just “going flat”—it’s a purposeful and beautiful closure that honors the body without implants or reconstruction.
Benefits of Aesthetic Flat Closure:
- No additional surgeries or implants required: Aesthetic Flat Closure (AFC) is a simpler, one-step process that eliminates the need for further surgeries, such as implants, revisions, or replacements. This can be a major benefit for women who want to avoid the complexity and potential complications of multiple surgeries over time.
- Minimal scarring and a natural, smooth look for some: While everyone’s body heals differently, many women who opt for AFC experience minimal scarring, with the chest wall being carefully closed for a smooth, flat appearance. This approach can result in a natural, clean look, allowing women to embrace their new shape with confidence.
- Low maintenance and fewer long-term medical risks: AFC requires less ongoing maintenance than breast reconstruction. There’s no need for regular monitoring or concern about implants, such as replacing them or dealing with complications like ruptures or capsular contracture. This results in fewer long-term medical risks and fewer follow-up procedures.
- No risk of Breast Implant Illness (BII): For those who are concerned about the potential effects of breast implants—like fatigue, brain fog, or joint pain—AFC offers a solution with no risk of Breast Implant Illness (BII). This can bring peace of mind for women who have concerns about the long-term impact of implants on their health.
- Encourages body positivity and self-acceptance: Choosing AFC is about honoring your body and embracing your new form. For many women, this option allows them to reconnect with their body in a way that promotes body positivity and self-love. It’s a way of accepting your body as it is, fostering emotional healing, and finding strength in your journey.
For me, choosing AFC meant reclaiming my body on my own terms. It allowed me to return to my normal life as quickly and peacefully as possible—free from unnecessary pain, complications, and a prolonged medical journey. I chose to focus on healing fully, emotionally and physically, without being defined by my breasts. “Spirit defines me, not my body.”
What is Breast Reconstruction?
Breast reconstruction involves recreating the shape of a breast using implants or tissue from another area of the body, such as the abdomen or back. While it may help some women feel more “like themselves” after surgery, it’s important to know that reconstruction is a complex medical process—not just a cosmetic fix.
One of the most advanced options available today is the DIEP flap reconstruction (Deep Inferior Epigastric Perforator flap). This method uses your own skin and fat from the lower abdomen—without taking any muscle—to form a new breast. It’s muscle-sparing, which helps preserve core strength and leads to a more natural look and feel. Many women appreciate that it avoids implants entirely while also offering a flatter tummy as a bonus benefit.
Benefits of Breast Reconstruction:
- Restores the appearance of breasts: For many women, breast reconstruction offers the opportunity to recreate the natural contour and symmetry of the breasts after mastectomy. This can help bring a sense of physical wholeness and visual normalcy, which some find important in their healing journey.
- Can improve body image for some women: Reconstruction may help restore confidence and a positive self-image, especially for those who feel emotionally connected to the presence of breasts. For some survivors, this procedure offers comfort in clothing, intimacy, and daily routines.
- Offers various customizable options to match personal preferences: Breast reconstruction is not one-size-fits-all. Women can choose between implant-based reconstruction or autologous (using their own tissue), with decisions guided by medical history, lifestyle, and personal goals. Surgeons often tailor results to fit individual body types and desires.
- DIEP flap may feel more natural and preserve strength: Since the DIEP flap uses your own tissue (not implants) and spares your abdominal muscles, it often provides a more natural look and feel. This method also maintains core muscle strength, which can improve long-term recovery and overall body function.
- May feel more natural to some individuals: When reconstruction is done using the body’s own tissue (such as a DIEP flap), the results may feel and look more natural compared to implants. This option can provide softness and warmth, which may be emotionally comforting for some.
However, reconstruction is not risk-free—and knowing the full picture matters.
Risks of Breast Reconstruction:
1 in 3 women experience complications
- ⚠️ Infections, bleeding, or poor healing
- ⚠️ Breast Implant Illness (BII) – symptoms include fatigue, joint pain, brain fog
- ⚠️ DIEP flap carries risks like abdominal weakness, longer recovery, or rare flap failure due to blood supply issues.
- ⚠️ Capsular Contracture – painful scar tissue hardening around the implant
- ⚠️ Implant rupture or leakage requiring replacement surgeries
- ⚠️ Multiple surgeries often needed over a lifetime
- ⚠️ Emotional and physical recovery is longer
- ⚠️ Significant cost – often averaging $89,000 or more in total medical expenses
Making an Informed, Empowered Choice
Choosing between Aesthetic Flat Closure and Breast Reconstruction is deeply personal. It’s not about what others expect—it’s about what makes you feel whole, comfortable, and confident. There is no one right answer—only the answer that feels right for you.
For me, AFC was the healthiest, most empowering choice. It gave me peace of mind, allowed me to heal without fear of complications, and helped me return to my everyday life with strength and self-love. I hope sharing my experience helps others feel less alone and more equipped to make a decision that aligns with their values.
Whether you choose to reconstruct, go flat, or are still unsure—just know this: Your body, your decision, your peace of mind.
Let’s continue to support one another with compassion and honesty as we move through this journey of healing and self-discovery. Until next time.
Always be kind, x
Erica