Is Flat the New Black?

In a #MeToo era more survivors feel emboldened to go breast-free

This week marks my 10th anniversary of going flat, and I’m happy to say that flat is finally having its day.

When I chose to have a double mastectomy without reconstruction in 2009, at the age of 38, I didn’t know a single woman my age who’d gone flat. When I went to online support groups, all of the young breast cancer folks were making lemonade out of their diagnosis and getting implants and tissue flaps. I watched from the sidelines as they cheered each other on through eight-hour surgeries, multiple infections, and months of recuperation. I desperately wanted to fit in with my peers, but my gut instinct was to keep my muscles as intact as possible. And, so, I went flat, even though I felt like the odd woman out.

At the time, I comforted myself with the knowledge that I was not as alone as I felt. I was a woman’s health journalist who wrote about breast cancer. I knew that, in the United States, about 25 percent of women who undergo bilateral (double) mastectomy stay flat. The number of flatties doubles to 50 percent among women who choose unilateral (single) mastectomy after breast cancer. Given that 3 million breast cancer survivors are alive today, that’s a lot of women with missing breasts. Where were they?

Years passed before I saw another person whose body looked like mine. She stepped onto the subway car on a hot August afternoon in downtown Boston. The heat and humidity caused her thin blouse to cling to her chest. My eyes snagged on a familiar concavity of her chest. The way she held herself – proud and upright. That day, on a packed subway car, was the closest I’ve ever come to hugging a stranger.

Today, the representation of flat women in popular culture blows my mind. Recently, several flat celebrities have “come out,” including Tig Notaro, Kathy Bates, and Anjelica Huston. Last year, flat breast cancer survivors were featured on the Today ShowCBS Sunday Morning, and on the front page of the New York Times. Ten years ago I never could have imagined seeing the choice to go flat celebrated and discussed in these public spaces.

Maybe it’s the influence of #MeToo or the rise of women’s voices and power in this country, but the current zeitgeist of “flat pride” has arrived. And I am buoyed by a groundswell of love and support. Finally, after years of feeling alone, I’ve found my people. They are flat. And they are beautiful.




Catherine Guthrie, author of FLAT: Reclaiming My Body From Breast Cancer, is an award-winning women’s health journalist. For the past twenty years, her reporting, essays, and criticism have appeared in dozens of national magazines including Time; O, The Oprah Magazine, Slate; Cosmopolitan; Prevention; and Yoga Journal. She has faced breast cancer twice. She lives near Boston, Massachusetts.

Catherine will be reading from FLAT this Friday (March 8) at 7:30PM at BookWoman in Austin. For details, go to
This Saturday (March 9), at 1:15PM, during the Young Survival Coalition’s National Summit, Catherine
Guthrie is teaching a breakout session on breast cancer advocacy called “Raise Your Voice!”


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  • Lisa Reply

    What about sex and how you felt and how your partner felt?

  • Rachel Matthews Reply

    Thank you so much for your reading last night. Gave me lots to think about…
    Yoga on! 😊

  • 'Sam' Reply

    I love this site & the fact that you have bravely chosen to go ‘flat’. I’ve have been a surgical technician for over 25 years. I have seen all of the options out there. Long ago I had decided that if I did need a mastectomy (which has not happened yet) that I would have a double mastectomy & nothing else. All my Dr’s thought I was crazy, but after all the redos & problems I’ve witnessed, none of those procedures would be an option for myself. I’m so thrilled to see brave women, such as yourself standing up against the ‘norm’ as I’ve seem the brutal rebuttal of just my opinion, even when I wasn’t the patient. I realize that most paitents do have a very good outcome & look great post-op, but I’m not willing to gamble on that. I would choose the very same option as you. If I ever have to face this, I now know that I will not be alone. Thank you!

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