A mastectomy removes breast tissue, requiring patients to decide how the chest wall will be restored. While many choose breast reconstruction with implants or tissue flaps, a growing number are opting for Aesthetic Flat Closure (AFC). This choice is not merely the absence of reconstruction, but a specific commitment to a carefully contoured chest wall. AFC provides a defined, smooth, and symmetrical result that aligns with the patient’s preference for a flat body form post-surgery.
Defining Aesthetic Flat Closure
Aesthetic Flat Closure is a precise form of chest wall reconstruction distinct from a standard flat closure. It is a surgical commitment to crafting a smooth and even plane across the chest wall after tissue removal. The term “aesthetic” signifies the surgeon’s focused skill in eliminating residual skin folds, bulges, or pockets of tissue often referred to as “dog ears.” The National Cancer Institute recognizes AFC as a type of surgery performed to rebuild the shape of the chest wall to appear flat.
The Surgical Process
Achieving a flat and smooth aesthetic result requires specific technical modifications beyond a typical mastectomy closure. The surgeon must carefully manage the remaining skin flaps, ensuring uniform thickness to prevent an uneven or “scooped-out” appearance. This involves meticulous contouring of the surrounding soft tissue, especially toward the sides of the chest and under the armpits. The surgeon precisely excises any excess lateral tissue that could otherwise form bulges or pucker marks. A technique known as obliteration of the inframammary fold is performed to remove the natural crease beneath the former breast, ensuring the scar does not create a false contour.
Patient Decision Factors
The decision to choose Aesthetic Flat Closure is deeply personal and driven by various practical and emotional factors. Many patients prefer AFC because it minimizes the number of surgeries required, often completing the entire process at the time of the initial mastectomy. This “one-and-done” approach streamlines the recovery timeline compared to multi-stage reconstruction procedures. Choosing AFC also allows patients to avoid the potential long-term complications and maintenance associated with breast implants or the additional scars from flap surgery. Some individuals simply prefer a flat body contour, while others may have medical conditions that make them poor candidates for more extensive surgeries.
Achieving the Final Aesthetic Result
The final aesthetic outcome of a successful flat closure is a smooth, clean contour that lies flush against the chest muscle. Scars are typically linear, running horizontally or slightly curved across the chest, with the exact pattern depending on the patient’s anatomy. Skilled surgical technique focuses on placing these scars symmetrically and discreetly. The term “flat” means the chest surface should be a smooth plane without lumps, divots, or excess skin. Patients report high satisfaction with their physical appearance, finding the streamlined look proportional and balanced, which contributes positively to body image acceptance.