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Flat closure after mastectomy

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Aesthetic flat closure after mastectomy is contouring of the chest wall after mastectomy without traditional breast reconstruction.[1] Vernacular synonyms and related vernacular and technical terms include "going flat",[2] "flat closure",[3] "optimal flat closure",[4] "nonreconstructive mastectomy",[5] "oncoplastic mastectomy",[6] "non-skin sparing mastectomy",[7] "mastectomy without reconstruction",[8] and "aesthetic primary closure post-mastectomy".[5]

Women who have decided against traditional reconstructive surgery following mastectomy have gained media visibility in recent years.[9] Media reports have covered patients' claims that their choices not to undergo reconstruction have been overridden by their surgeons.[10][11] Recent research has characterized the "going flat" movement and patient experience going flat[12][13][14] and described aesthetic flat closure surgical technique.[15][16][17]

Aesthetic flat closure is the surgical work required to produce a smooth flat chest wall contour after the removal of one or both breasts, including obliteration of the inframammary fold and excision of excess lateral tissue (to avoid "dog ears.")[17][18] It is defined by the National Cancer Institute as the following: "A type of surgery that is done to rebuild the shape of the chest wall after one or both breasts are removed. An aesthetic flat closure may also be done after removal of a breast implant that was used to restore breast shape. During an aesthetic flat closure, extra skin, fat, and other tissue in the breast area are removed. The remaining tissue is then tightened and smoothed out so that the chest wall appears flat."[19]

References

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  1. ^ "About Aesthetic Flat Closure". BreastCancer.org. 2011-02-02. Retrieved 2022-08-12.
  2. ^ Rabin, Roni Caryn (2016-10-31). "'Going Flat' After Breast Cancer". The New York Times. ISSN 0362-4331. Retrieved 2020-07-03.
  3. ^ "NCCN Guidelines for Patients: Invasive Breast Cancer". NCCN.org. Retrieved 2022-08-12.
  4. ^ "OPBC". oncoplasticbc.org. Retrieved 2020-07-03.
  5. ^ a b Djohan, Michelle; Knackstedt, Rebecca; Leavitt, Tripp; Djohan, Risal; Grobmyer, Stephen (April 2020). "Technical considerations in nonreconstructive mastectomy patients". The Breast Journal. 26 (4): 702–704. doi:10.1111/tbj.13641. ISSN 1524-4741. PMID 31578792. S2CID 203652994.
  6. ^ Macmillan, R. Douglas; McCulley, Stephen J. (2016). "Oncoplastic Breast Surgery: What, When and for Whom?". Current Breast Cancer Reports. 8 (2): 112–117. doi:10.1007/s12609-016-0212-9. ISSN 1943-4588. PMC 4886147. PMID 27330677.
  7. ^ Kinoshita, Satoki; Nojima, Kimihiro; Takeishi, Meisei; Imawari, Yoshimi; Kyoda, Shigeya; Hirano, Akio; Akiba, Tadashi; Kobayashi, Susumu; Takeyama, Hiroshi; Uchida, Ken; Morikawa, Toshiaki (2011). "Retrospective comparison of non-skin-sparing mastectomy and skin-sparing mastectomy with immediate breast reconstruction". International Journal of Surgical Oncology. 2011: 876520. doi:10.1155/2011/876520. ISSN 2090-1410. PMC 3263672. PMID 22312528.
  8. ^ Harcourt, Diana M.; Rumsey, Nichola J.; Ambler, Nicholas R.; Cawthorn, Simon J.; Reid, Clive D.; Maddox, Paul R.; Kenealy, John M.; Rainsbury, Richard M.; Umpleby, Harry C. (March 2003). "The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study". Plastic and Reconstructive Surgery. 111 (3): 1060–1068. doi:10.1097/01.PRS.0000046249.33122.76. ISSN 0032-1052. PMID 12621175. S2CID 1445626.
  9. ^ "Why More Breast Cancer Survivors Are Going Flat". Oprah.com. Retrieved 2020-07-03.
  10. ^ Guthrie, Catherine (2018-09-06). "These Cancer Patients Wanted to Get Rid of Their Breasts for Good. Their Doctors Had Other Ideas". Cosmopolitan. Retrieved 2020-07-03.
  11. ^ "Breast cancer patient opens up about alleged malpractice in surgery". TODAY.com. Retrieved 2020-07-03.
  12. ^ Wakeley, Michelle E.; Bare, Colette F.; Pine, Rebecca; Dube, Catherine; Gass, Jennifer S.; Taneja, Charu; Dizon, Don S. (2020). "A social media survey of women who do not pursue reconstruction after mastectomy for breast cancer: Characterizing the "Going Flat" movement". The Breast Journal. 26 (7): 1455–1457. doi:10.1111/tbj.13781. ISSN 1524-4741. PMID 32067326.
  13. ^ "SABCS iPosters". posterview.com.
  14. ^ "Going Flat After Mastectomy". 23 May 2020.
  15. ^ Djohan, Michelle; Knackstedt, Rebecca; Leavitt, Tripp; Djohan, Risal; Grobmyer, Stephen (2020). "Technical considerations in nonreconstructive mastectomy patients". The Breast Journal. 26 (4): 702–704. doi:10.1111/tbj.13641. ISSN 1524-4741. PMID 31578792. S2CID 203652994.
  16. ^ Smith, Monica J. (December 10, 2018). "Managing Patient Expectations Key for Mastectomy Without Reconstruction". Clinical Oncology News. Retrieved 2020-07-03.
  17. ^ a b Morrison, Kerry A. (May 2022). "Not Just a Linear Closure: Aesthetic Flat Closure after Mastectomy". Plastic and Reconstructive Surgery - Global Open. 10 (5): e4327. doi:10.1097/GOX.0000000000004327. PMC 9116949. PMID 35620492. S2CID 248837570.
  18. ^ Hill, Erica L. (July 2019). "The Angel Wings Incision: A novel solution for mastectomy patients with increased lateral adiposity". The Breast Journal. 25 (4): 687–690. doi:10.1111/tbj.13301. PMID 31111601. S2CID 160011773.
  19. ^ "NCI Dictionary of Cancer Terms - National Cancer Institute". cancer.gov. 2011-02-02. Retrieved 2020-07-03.
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