Original articlesSatisfaction Outcomes in Women Who “Choose to Go Flat” After Mastectomy An Integrative ReviewTyner, Tracy E. MSN, APRN, ACNP-BC; Lee, Mikyoung A. PhD, RNAuthor Information Texas Woman's University College of Nursing, Denton. Correspondence: Tracy E. Tyner, MSN, APRN, ACNP-BC, Texas Woman's University College of Nursing, PO Box 425498, Denton, TX 76204 ([email protected]). The authors acknowledge Elaine Cox, MLIS, Health Sciences Librarian, at Texas Woman's University, Denton, Texas, for her assistance with the literature search strategy. The findings and conclusions in this integrative review are those of the authors and do not represent the official position of Texas Woman's University College of Nursing. The authors have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Advances in Nursing Science: January/March 2021 - Volume 44 - Issue 1 - p 31-51 doi: 10.1097/ANS.0000000000000329 Buy Take the CE Test Metrics Abstract A considerable number of women undergoing mastectomies are “choosing to go flat,” forgoing reconstruction. This integrative review sought to identify satisfaction outcomes and relevant factors among these women. Using variations of the key word “going flat,” a systematic search of 7 databases was conducted. Fifteen articles met the inclusion criteria and were reviewed. Decisional and breast/chest appearance satisfaction in women who did not have reconstruction was mixed when compared with other surgical options. Body image, body mass index, radiation therapy, and access to information/resources affected satisfaction. Nurses are in a pivotal role to address the communication and informational needs of these women to support optimal surgical decision-making processes and improve patient satisfaction and clinical outcomes. © 2020 Wolters Kluwer Health, Inc. All rights reserved.