Dr Simran Malhotra on aesthetic flat closure

Dr Simran Malhotra on aesthetic flat closure

Dr Simran Malhotra

Simran Malhotra, MD, is a triple board-certified physician in internal medicine, hospice and palliative care, and lifestyle medicine, as well as a certified health and wellness coach. She is a BRCA1 previvor with a strong family history of breast and female reproductive cancers, and underwent a risk-reducing bilateral mastectomy and total hysterectomy in 2020 at 32 years old. After learning about her own genetic risk of cancer, and grounded in her professional experiences in palliative care, she founded Wellness By LifestyleMD, a platform where she works with and educates women at high risk for cancer with or without genetic mutations on the powerful impact that positive lifestyle changes can have on their quality of life and even longevity. Read on to learn about her choice to have an aesthetic flat closure:

When I had my breast and plastic surgery consults, I was told by multiple doctors that I was the perfect candidate for direct to implant after my mastectomy. There was only one issue - I went into my consults knowing I didn't really want implants. So, I did my own research. I found an option that worked for me and a team of doctors who listened to what I wanted for my body, despite others telling me I was making the wrong decision.

As a palliative care physician, I am very passionate about the patient’s informed consent, which means they understand the risks, benefits, and all the treatment options available, not just the ones that the doctor thinks you should do.

From my own personal experience & others, most breast and plastic surgeons do not tell women about all their choices. They should give them information about implants, flaps, and options to leave the area flat.

A study published in @jamanetwork , showed that most women do not have a good enough understanding of the risks vs. benefits of reconstruction, especially the complications. Some women confuse getting a breast augmentation with reconstruction after mastectomy - they are not the same thing.

Dr Simran Malhotra with her kids

So, what is flat closure?

Aesthetic Flat Closure is an option post mastectomy that is not as common as traditional reconstructive options but is becoming more popular. It offers a way to close the mastectomy site without reconstruction, providing a natural flat look where the breast once used to be. In flat closure, excess skin, fat and other tissue are removed to create an aesthetically pleasing smooth flattened chest.

Why did I choose flat?

Personally, I felt that my breasts had fulfilled their purpose in my life. They played a key role in my children's lives, and I knew replacing them wouldn't be the same. I didn't want to have multiple surgeries or risk any additional complications. And most importantly, I was confident that my feminity and womanhood is not defined by me having breasts.

Here is my advice for anyone considering their options post mastectomy:

Choosing reconstruction vs. no reconstruction after a mastectomy is a VERY personal decision. Be your own advocate. Do your own research & educate yourself on all the possible options. Talk to other women & listen to their experiences. Get a second medical opinion if needed.

There is no wrong decision and what each woman chooses is the right decision for her, as long as she is given all her options and it is an informed decision.

You know yourself best. Do not let anyone - even doctors - tell you how your body should look or feel. Or how you should feel about yourself if your body looks a certain way. Just remember, you are beautiful no matter what!

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