Aesthetic Flat Closure

All women undergoing mastectomy without reconstruction should undergo aesthetic flat closure. The basic principles in a normal-sized patient include complete removal of the breast crease, aggressive removal of excess skin, and skillful reshaping and contouring of the tissue above and below the mastectomy incision, leaving behind a smooth and gentle profile.



What is an Aesthetic Flat Closure?

Aesthetic flat closure is performed in women who decide against breast reconstruction and prefer to be left as flat as possible. Many women are left with excess skin and fat hanging off their sides and their chests after mastectomy surgery. This is usually because the surgeon is not trained in the technical details required to leave women with an aesthetic flat closure. It is both unsightly and uncomfortable. Women may undergo aesthetic flat closure after either unilateral or bilateral mastectomy. They may also seek this surgery after their cancer surgeon has left them with too much excess skin and fat after their first surgery.  Special approaches are needed in obese patients who desire aesthetic flat closure as they have significantly more excess fat and skin in and around the breast.  

Who needs an Aesthetic Flat Closure?

Any woman undergoing unilateral or bilateral mastectomy who is certain she does not desire breast reconstruction is a good candidate for an aesthetic flat closure. In fact, all women who choose to forego breast reconstruction after mastectomy should undergo an aesthetic flat closure. Aesthetic flat closure removes all evidence of the previous breast, removing all the excess skin, the breast crease, and any tissues along the sides and between the breasts.

Obese patients require additional special approaches to successfully remove all their excess skin and fat along their sides. Dr. Schwartz has both lectured on these approaches and published his techniques for providing these more complex patients with an Aesthetic Flat Closure.  

Consultation and Procedure

During your consultation, Dr. Schwartz will determine if you require a simple Aesthetic Flat Closure or the more complex approach required in obese patients.  He will also explain and set the right expectations for your surgical outcome. Thanks to Dr. Schwartz’s access to a private Outpatient Surgery Center, his patients can expect to have their Aesthetic Flat Closure scheduled within 1-2 weeks. Aesthetic Flat Closure after mastectomy, just like any other breast cancer diagnosis and treatment, is covered by health insurance companies.

During the procedure, Dr. Schwartz will remove all your excess skin and fat along your front and sides to leave you as flat as possible. Two or three drains are placed on each side which are removed in 1-2 weeks. This surgery is performed under general anesthesia and takes approximately 45 to 60 minutes for one side and 90 to 120 minutes for both sides depending on breast size. Surgery is usually performed at our Ambulatory Surgery Center and patients are discharged home the same day.

During your surgery, Dr. Schwartz will usually sample the lymph nodes under your arm to stage your cancer and help other specialists decide whether you might need chemotherapy and/ or radiotherapy more accurately. Dr. Schwartz tries to minimize the number of lymph nodes removed, while still completely removing all cancer, to minimize your chances of developing lymphedema (swelling of the arm).

Recovery and Results

Recovery after mastectomy and aesthetic flat closure takes approximately two weeks and any additional chemotherapy or radiation therapy required starts usually no sooner than four weeks after surgery depending on healing. Patients can be fitted for a prosthetic bra approximately three months after surgery.  All breast tissue and lymph nodes that are removed are sent to a laboratory for analysis. The results of your pathology report should be available within a week or two after your mastectomy.

Jean-Claude Schwartz, MD, PhD
Top Breast Surgeon In Atlanta

Breast Cancer & Reconstruction Surgeon

Dr. Schwartz is an internationally trained and recognized leader in the field of oncoplastic breast surgery.  He is rightfully referred to as the Top Breast Surgeon In Atlanta as there is no purely trained breast cancer surgeon in the United States with a more comprehensive reconstructive skillset nor who has made more original contributions to the varied areas of oncoplastic breast surgery than Dr. Schwartz. He is one of only two surgeons in Georgia, and a handful in the US, capable of breast tumor removal and immediate reconstruction in just one surgery. With over 6,000 surgeries performed, Dr. Schwartz is constantly perfecting and innovating new oncoplastic techniques to further improve a women’s breast appearance after breast cancer surgery.

A good word means a lot

Client testimonials


It’s always the word of mouth that’s the best advice. Here are some of our client testimonials.
4.9-star rating, over 6000 surgeries completed.

SCHEDULE YOUR Aesthetic Flat Closure TODAY!

Dr. Schwartz is dedicated exclusively to breast surgery and reconstruction, and he has devoted his life to perfecting the appearance of women diagnosed with breast cancer. As a cancer survivor himself, Dr. Schwartz is known for his genuine compassion and unsurpassed commitment to providing the best surgical care tailored to each patient’s individual needs and desires. His innovative procedures and techniques allow him to offer his patients the widest range of surgical options available anywhere.