Flattops: Articles: Fully Flat


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    Fully Flat: A Look at Living Prostheses-Free

    by Melissa

    Do you wear bilateral prostheses? If so, do you wonder what it might feel like not to "have" to wear them? Or, are you about ready to have mastectomies, and wonder if heavy prostheses are the only choice available to you?

    I grew up as the daughter of a woman who had cancer four times. She lost one breast to cancer when I was a very young child, and the other when I was in my teens. She decided to always wear prostheses, except when in her pajamas. To be honest, I always considered her prostheses "gross." Perhaps it is their natural feel and weight, but they seemed like detached body parts to me. Of course, this is how prostheses are supposed to feel--like natural tissue.

    There are other reasons--generally more sensible than prostheses being "icky!"--that women may choose not to wear them. It could be a matter of money or comfort. Prosthetics that have been deemed by some to be a "medical necessity" to wear are as heavy as natural tissue, and also do not "breathe" since they are made of silicone.

    In fact, many prosthetic devices are actually a choice. I have known people who have lost fingers, for example, and have never noticed them wearing false fingers. Conversely, a person who has lost a leg has a practical reason to wear a prosthetic device. In many cases, people wear prosthetic devices only when they serve a practical purpose.

    Additionally, people may prefer to wear a product that is more comfortable or that does a better job. For example, a person who has lost an arm may choose to wear a practical, light metal mechanical prosthetic arm rather than one that looks real but is heavy and has less function.

    Many women with mastectomies, however, have been told that wearing heavy prostheses is a medical necessity.

    Medical Necessity?

    There is a lot of information circulating out there that states that not wearing prostheses will result in various medical problems, from shoulder to back to jaw issues. Unfortunately, it is tough to know where selling begins and truth ends. I would certainly not argue with a doctor if he or she has substantiated proof about this. However, it has been noted that some of these facts and figures may actually come from a non-regulated prosthetics industry. What better way to sell a product than to convince insurance companies and patients that it is a medical necessity to wear prostheses?

    A medical article sheds light on the fact that this may be a marketing scheme (you will have to register with Medscape, which is free--this article is definitely worth reading). According to Irene R. Healey, B Sc, author of External Breast Prostheses: Misinformation and False Beliefs, "The majority of information on breast prostheses is provided by the manufacturers and tacitly accepted by healthcare providers and the media in general." The author believes these claims are merely that: claims. In fact, she goes so far as to call them "false." I highly recommend reading the entire nine-page (when printed) article, because it contains many references and tries to weed out fact from fiction as far as breast prosthetic medical claims go. The author, Irene R. Healey, seems to be correct that there needs to be far more independent research in this area.

    However, let us suppose for a moment that breast prostheses are not a medical necessity. If you knew that they were not, would you still choose to wear them?

    If the answer is "no," then you may be surprised to find out that there are other women out there who also choose not to wear breast prostheses. Your first question may be,

    Won't People Notice?

    A family member told me that when she worked in a nursing home, she cared for a lady for quite some time. She didn't realize until one day that she had to bathe the woman that she was flat as a board, and had had bilateral mastectomies!

    Believe it or not, women who do not wear prostheses can relate similar stories from their own experiences.

    As for me, I have an outspoken friend. I went to her place rather soon after my surgery, and kept fidgeting with my shirt, and squirming in the chair. I chose not to tell her the nature of my surgery, because she would be the type of person to pass it around. To me, my mastectomies are something private and something I do not want the entire world to know. (Of course, everyone is different in how much they want to reveal.) The entire time I visited with her, I sat in that chair and squirmed and squirmed. As the time passed, it became obvious to me that she was not paying the least bit attention to my personal appearance. Another time soon after my surgery, a friend (this time one who did know about my mastectomies) came for a visit. She never mentioned my surgery, so I finally casually noticed my flat appearance. She immediately told me that it had escaped her mind and she hadn't really noticed.

    So as the time passes, of course, I have lost some of my fears about being "found out." In fact, there seemed to be only one person who ever noticed and mentioned my flatness. I was wearing a tight sweater which did not hide any of my flatness, and was getting my blood pressure taken by a nurse. Due to the mastectomies, I wanted to warn her to keep it low so as not to squeeze my arm too tightly. She said, "Oh! You could get reconstruction. They just 'pop 'em in.'" That is the only example of someone who has noticed and commented upon it. For the most part, people--including doctors--seem to assume I have "something on" or had reconstruction. Even lying down in a dentist's chair, my flatness went unnoticed.

    When out and about, I assume people consider me to be an AAA, if they even look. I'm no Pamela Anderson, and my feeling is that she is the type of person--a woman spilling out from a low-cut shirt--who gets all of the types of glances that I'm attempting to avoid!

    Which leads us to the next subject . . .


    Some people would assume someone who does not wear prostheses is not feminine. This is not necessarily so. Remember that little girls do not have these curves, either, yet they can look equally as feminine with their clothing, hairstyles, demeanor, etc.

    Women may worry that men will not find them attractive. I don't go to places such as bars or singles places. However, I have noticed no difference whatsoever in the way I am treated by the opposite sex.

    Being attractive is a reflection of how you feel about yourself. So, as far as prostheses go, it really depends on what makes you comfortable enough to be self-confident. A Bible passage I find relevant to this is from 1 Peter 3:4-5 "Your beauty should not come from [the] outward [appearance]. . . . Instead, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God's sight. For this is the way the holy women of the past who put their hope in God used to make themselves beautiful."

    My favorite quote from the--rather random--book Uncle Tom's Cabin is this: "So much has been said and sung of beautiful young girls, why don't somebody wake up to the beauty of old women?" The author, Harriet Beecher Stowe, goes on to say, "For what? for twenty years or more, nothing but loving words, and gentle moralities, and motherly loving-kindness, had come from that chair--headaches and heart-aches innumerable had been cured there--difficulties spiritual and temporal solved there--all by one good, loving woman. God bless her!" This is not to say that all of us who have had mastectomies are old women, of course! However, there are certain things that make someone attractive that have nothing to do with the outer form.

    Incidentally, according to a study, those who opt for mastectomies without reconstructive surgery statistically report less negative impact on (er) "being romantic" than those who opt for reconstruction.


    To be honest, I do notice my stomach a lot more than I ever did. Not that my stomach has necessarily gotten larger, but clothes drape a lot differently than they used to. On the bright side, this encourages me to stand up straight!

    Any woman who undergoes a mastectomy procedure has to get used to having a new body, a new shape. She may feel more comfortable in different clothing than she did before. I always used to wear sweaters during the winter, for example. I have since found that sweaters make me look more flat than any other type of top I could wear.

    There are adjustments that have to be made by each and every woman who has had a mastectomy, whether she chooses to wear prostheses or not.

    In Conclusion

    My goal is not to make all women who have had mastectomies run around without bras on. I own prostheses and plan to use them sometimes--if I ever can get over how comfortable it feels not to have to wear a bra! But I do feel that our society places far too much emphasis on conforming to certain standards of beauty. Because of this, we all inadvertently become highly self-conscious.

    Ironically, we are all so wrapped up in what we look like, that none of us really cares about what others look like! Which, when you think about it, is a positive thing for those of us who want to be comfortable and live "fully flat." Just remember, everyone else may be too busy to see you--they're all worrying about themselves!

    This website is for personal support information only. Nothing should be construed as medical advice. Please note that Melissa has written this article as a subjective article, not as a medical article. If you have any questions or concerns, ask your doctor.