Opting to ‘live flat’
Woman says she didn’t know not having reconstructive surgery was a possibility
Juliet FitzPatrick was always known for her big breasts. A double G cup, she had dressed for them, been used to people looking at them in public, and had fed two babies with them. Sure, they could be a pain at times, but they were a huge part of her identity. She would never have anticipated one day electing to have them removed.
FitzPatrick is among a growing number of women opting to “live flat” after breast cancer. Diagnosed in January 2016 at the age of 54, after a routine mammogram, she underwent a lumpectomy and soon faced the prospect of a single mastectomy and reconstructive surgery.
“It was probably the worst thing I’ve ever heard apart from ‘you have cancer,’” she recalls. “It was very much a case of ‘you have to have a mastectomy — this is what we’re going to do.’ The lovely nurse showed me lots of photos of women who had their mastectomy and then a reconstruction. I was totally in shock at that point.”
FitzPatrick was told that, following the mastectomy, she would have what is known as a “DIEP flap” procedure, where an incision is made along the bikini line and a portion of skin, fat and blood vessels is taken from the lower stomach, moved up to the chest and formed into a breast shape.
“I was told it would be great, it would be like having a tummy tuck, I’d be able to buy new jeans.
“There was no mention whatsoever of the other option, which was not having reconstruction.
“It was going to be an eight-hour operation, which was quite a scary thought. The recovery sounded difficult and traumatic, and the more I looked into it, the more I realized that it probably wasn’t just going to be one operation — there would be revisions, and I’d probably have to have an operation on my healthy breast to get them to match,” she says.
FitzPatrick asked if the surgeon could take both breasts off at once, but as there was no clear risk to her healthy breast, he refused. “It was a disappointment, but I could understand where he was coming from.”
She can still recall her daughter, Laura, convincing her to look for the first time after the initial operation.
“I found it really difficult but she said, ‘Come on just look at it.’ And that was the right thing, because, actually, it wasn’t as bad as I thought it would be.”
Forced to wait a year before having reconstructive surgery, by a course of radiotherapy, FitzPatrick grew accustomed to what she began to jokingly call her “uniboob.” The more she considered reconstructive surgery, the more doubts crept in.
“I think I actually googled ‘does everybody who has a mastectomy get reconstruction?’ And I discovered that, no, they don’t.
“I found a Facebook group called Flat Friends, which is for women who haven’t had reconstruction, and it was a great support. You could ask anything you wanted; people post their photos and their scars. They really helped me to think through what I wanted to do.”
Through Flat Friends — a charity that supports more than 2,000 women choosing to live flat — FitzPatrick discovered that thousands of women felt like she did. But it remains a route that many women are not aware is open to them. Flat Friends want women to be proactively provided with “practical information whichever surgical pathway they are considering.”
Though reconstruction didn’t appeal, FitzPatrick was finding her “uniboob” increasingly difficult to live with. “When I looked in the mirror, I liked my flat side more than the other. I had to still wear a bra to support my remaining breast. I didn’t want to go out lopsided, so I wore a really big prosthesis that was hot, unpleasant, uncomfortable, just miserable.
“Every time I saw my surgeon, I asked him if he would please remove the other breast because I just wanted to be symmetrical. He’d say no and ask me to think about it some more.”
Finally, sitting on the end of the bed after an appointment, she asked the doctor to look at her.
“How do you think this feels for me to have to live like this for the rest of my life?” she said. “He kind of looked at me, looked at the breast and went, ‘Yeah, OK. I understand.’”
A month later, FitzPatrick underwent an elective surgery to have her healthy breast removed. “It felt like it was such an outlandish thing to do, but my family were so supportive. I think they’d seen how miserable I felt.”
After the surgery, she felt instantly more herself.
“I was so glad I had done it. It felt quite empowering, and immediately I felt more at ease and more comfortable with my body.”
As she recovered from the surgery and became accustomed to her new shape, she resolved to help other women experiencing the turmoil she had been through.
“I want to advocate for women’s right to be given all of the options after a mastectomy, including the option to remain flat. And I want to increase the visibility of women who choose to live flat. I’ve discovered that I don’t need breasts to feel like a woman.”
Last year, FitzPatrick became involved with the Behind the Scars campaign, having a topless photograph taken, which later appeared in an ad everywhere from Piccadilly Circus in London to Times Square in New York.
“I never thought that my topless image would be on a billboard,” she says. “It’s just been amazing — very, very surreal.”
Does she ever miss her double Gs?
“I don’t think I do. I wish I hadn’t had cancer and had to go through all this, but I’ve tried to turn that into the positive experience I’m having now.”