Medical Oncologist
Before your operation
How to ask your surgeon for a good flat result
Ask for an aesthetic flat closure by name, rather than saying you do not want reconstruction. Those sound like the same request and they are not: one describes an operation with a planned result, the other describes declining something. This page sets out exactly what to ask for and how to handle being talked out of it.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
The short answer
How do I make sure I get a good flat result?
Ask for an aesthetic flat closure by name, rather than saying you do not want reconstruction. Those sound like the same request and are not. One describes an operation with a planned result; the other describes declining something, which can leave the closure as an afterthought.
Why the wording changes the outcome
A surgeon told a patient has declined reconstruction may close the wound in the standard way, leaving the skin that would have held an implant. A surgeon asked for a flat closure plans how much skin to remove and how to taper the edges.
Say it early, and say it more than once
The decision affects how much skin is removed, so it has to be known before the operation is planned rather than mentioned on the morning. Repeat it at the consent appointment.
Ask for it in your notes
Requesting that your preference is recorded is reasonable and takes a moment. It matters if a different surgeon ends up operating, or if a decision has to be made while you are asleep.
If you feel you are being talked out of it, that is worth naming in the room rather than afterwards.Take this list with you
What to ask for, specifically
- An aesthetic flat closure, named as such
- Excess skin removed, not left for a future reconstruction
- The edges near the armpit tapered, so there are no folds
- To be marked standing up, not lying down
- To see photographs of this surgeon's own flat results
- Your preference recorded in the notes and on the consent form
- To know who operates if your named surgeon is unavailable
The conversation
Handling the pushback you may meet
Most surgeons are supportive. These are the responses women report most often, and what to say.
You might regret it later
Answer that delayed reconstruction remains possible, so the decision is not final, and ask them to record that you have considered it. Regret is more associated with feeling pushed than with the choice.
You are still young
Age is a reason to be certain, not a reason to overrule you. Ask what specifically about your age changes the surgical recommendation, as opposed to the assumption.
A clear, informed preference should be respected.We will leave the skin in case
This is the one to push back on hardest. Preserved skin with nothing to fill it is exactly what produces a poor flat result. Say you want the closure planned as the final result.
Silence, and no discussion at all
Flat closure is sometimes simply not offered. If reconstruction was presented as the only path, ask directly what a flat closure would involve here and who performs them.
If you are not heard
- Ask for it in writing in your notes
- Bring someone to the next appointment
- Ask to see another surgeon
Not sure whether this applies to you?
Ask an oncologistTalk to our team
Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Words to use
The vocabulary that gets you understood
- Aesthetic flat closure
- The phrase to use. It names a planned, contoured result rather than the absence of a reconstruction.
- Dog ears
- Folds of skin left at the ends of the scar. Naming them shows you know what a poor result looks like.
- Contouring
- Tapering the tissue so the chest lies smooth under clothing. The part that distinguishes a planned closure.
- Skin-sparing
- Deliberately preserving skin for a reconstruction. This is what you are asking them not to do.
- Marked standing
- Planning the incision with you upright, because that is how gravity will hold the tissue afterwards.
- Revision
- A later operation to tidy an unsatisfactory result. Worth knowing it exists, and better avoided.
Being straight with you
What to expect from the conversation
Most surgeons will accept a clear preference without difficulty. Where women report trouble, it is usually an assumption rather than an argument: reconstruction gets described as the default and flat closure never gets discussed as an option with its own technique.
Not every surgeon does them well
A flat closure is a straightforward operation done carefully, and surgeons who rarely plan for one produce less tidy results. Asking to see their own photographs is not rude; it is the same question you would ask about a reconstruction.
A poor result can usually be revised
If you have already had surgery and were left with folds or an uneven contour, a revision to tidy it is generally simple. You do not have to accept a result that was never planned.
Bring someone with you
Not for support alone. A second person makes it considerably harder for a preference to be quietly passed over, and they will remember what was agreed when you do not.
Ask who operates if your surgeon is away
Lists change, and a colleague may step in. A preference recorded in your notes travels with you in a way a conversation does not. Ask who would operate in that situation and whether they perform flat closures routinely.
This is your decision
How your body looks and feels afterwards is something you live with and nobody else does. A surgeon can tell you what is safe. They cannot tell you what you should want.
Commonly believed
What gets said in the consulting room
Asking for photographs will offend the surgeon.
It is a normal request and one they field regularly for reconstruction. Asking the same about a flat closure signals that you expect it to be planned with the same care, which is exactly the point.
Leaving extra skin keeps my options open.
It compromises the result you have actually chosen. Skin preserved for an implant and left unfilled has nowhere to go, which is the commonest cause of folds. Delayed reconstruction remains possible without leaving that skin.
If I insist, I will be labelled difficult.
Stating a clear preference and asking for it to be recorded is ordinary, and good teams document patient choices routinely. If a reasonable request genuinely provokes a poor reaction, that tells you something useful.
It is too late now, my surgery is already done.
If you were left with folds or an uneven chest, a revision to tidy it is usually straightforward surgery. Raise it at follow-up rather than assuming the result you were given is the one you must keep.
Questions we are asked
Common questions about asking for a flat result
When should I raise it?
At the first surgical consultation, before the operation is planned, because it changes how much skin is removed. Repeat it at the consent appointment and ask for it to be written in your notes, in case a different surgeon operates.
What if my surgeon has never been asked before?
Ask who at the unit does perform them and whether you can see that person. Requesting a referral to a colleague with more experience of a particular technique is ordinary practice rather than a criticism.
Should I put it in writing?
Asking for it to be recorded in your notes and reflected on the consent form is enough. You can also bring a short written statement of your preference to the appointment, which some women find makes the conversation easier.
Can I change my mind after saying this?
Yes, up until the operation. Tell the team as early as you can, because the surgical plan differs. Afterwards, delayed reconstruction remains possible, though it will usually need your own tissue.
What if the result is not what I asked for?
Raise it at follow-up and ask what revision is possible. Tidying folds or an uneven contour is usually straightforward. Ask to see photographs of what the revision would achieve before agreeing to more surgery.
Does asking for this delay my surgery?
It should not. It changes the plan rather than adding steps, and a flat closure is usually a shorter operation than a reconstruction. If it is being used as a reason to postpone, ask why specifically.
Will my family's opinion be asked?
The decision is yours. Family can be present and involved, and often should be, but consent belongs to you. If you feel a relative is being deferred to over your own stated preference, say so directly.
Is there anyone who can advocate for me?
Your breast care nurse is usually the most effective person, and part of their role is making sure your preferences reach the surgical team. Ask to speak to them separately if the consultation felt rushed.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. Each centre also names the areas it serves, so you can place it without a map. Consultation and day-care Chemotherapy run at every one of them.
Warangal
Vizag
Talk to our team
Speak to a breast cancer specialist
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Sources
- Cancer Research UK — Mastectomy without reconstruction
- National Cancer Institute — Breast reconstruction after mastectomy
- Breast Cancer Now — Living without reconstruction
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.