Topless protest alleges malpractice over breast-cancer surgery: 'Paternalism at its finest'

Beth Greenfield
Senior Editor
Kim Bowles, top left, led a handful of in-person supporters and great many online for a protest of the Cleveland Clinic, where, she alleges, a surgeon was unethical. (Photo: Courtesy of Kim Bowles)

It was a topless protest like no other: A determined woman marching through Cleveland, Ohio, not only without a shirt, but without breasts.

Kim Bowles, a Pittsburgh scientist and mother of two, had undergone a double mastectomy following stage-3 cancer treatment in 2017, and had chosen to “go flat” — opting out of the complex breast reconstruction surgery that follows the majority of mastectomies. But instead, she says, her Cleveland Clinic surgeon blatantly ignored her wishes, leaving extra flaps and pouches of skin on her chest in case she were to “change her mind” in the future. Bowles calls that “paternalism at its finest,” and Saturday’s protest was a way, she said, “to put the malpractice into the public eye,” and to send the following message: “I’m not going away.”

Kim Bowles, during a livestream of her protest, showing her unwanted mastectomy result along with several others. (Photo: Courtesy of Kim Bowles)

She was joined on Saturday by a handful of supporters wearing shirts, ironically, bearing the name of the march, “Not Putting on a Shirt.” A “virtual march” was way more populated, as supporters — many of them women who had also undergone mastectomies and had opted out of reconstruction, to varying results — posted photos on Facebook and Instagram, either topless or in the official march T-shirts. Some even single-handedly held sister protests in other cities.

“Being flat shouldn’t be something you have to fight so hard to have respected,” wrote one supporter on Facebook.

“At no point did I ever consider reconstruction, ever,” Bowles tells Yahoo Lifestyle, explaining that she felt the risky, complex surgery that uses either implants or excess skin or tissue from elsewhere on the body was not, for her, worth the “aesthetic results.” (While women most often choose to reconstruct their breasts following a mastectomy — and even face pressure from surgeons to do so — more women now than ever now opting to go flat: About 25 percent of double-mastectomy patients and 50 percent of single-mastectomy patients forgo reconstruction, according to one study.) 

Bowles says she had a verbal a tussle with her surgeon just minutes before she was put under in the operating room. “Before they started the anesthetic drip, I heard [the doctor, who was standing behind her] say, ‘I’ll just leave a little extra in case you change your mind,” Bowles recalls about the moments preceding her surgery. “I turned and said, ‘Don’t — make it flat.’” She’d already had many pre-surgery consults, during which she shared photos of how she wanted her chest to look. But when Bowles woke up from surgery in February 2017, she saw, to her horror, that the doctor had not listened. He had instead appeared to have given her what’s called a “skin-sparing mastectomy,” which leaves space for reconstruction.

“It was paternalism at its finest,” she said. “I felt like, I just experienced what amounted to a rape. I was physically assaulted. It wasn’t sexual. But I was kind of in shock.” When she confronted her doctor about the unwanted flaps at her follow-up visit, she said, “He denied it, and told me, ‘It will tighten up.’”

The Cleveland Clinic shared the following statement with Yahoo Lifestyle: “Taking care of patients is our top priority. In this instance, Ms. Bowles chose to have a double mastectomy after having chemotherapy for her tumor. Per her wishes, she opted not to have further surgical revisions that are common for patients who have had mastectomies. The physicians involved in her care have outstanding reputations and are highly skilled. We conducted three thorough reviews relating to her concerns and shared with her that it was determined every aspect of her care was done optimally to give her the safest amount of extra skin to prevent jeopardizing her arm movement.”

But at least one other surgeon called BS on that concept. “That’s bullsh*t. Leaving the excess skin — it’s no easier to move the arms either way,” Deanna Attai, M.D., a breast surgeon and assistant clinical professor of surgery at the David Geffen School of Medicine at the University of California, Los Angeles, told Cosmopolitan, which wrote about Bowles’ and other women’s stories, and received the same hospital statement.

Bowles got herself another surgeon to follow her through her aftercare, and went to the ombudsman of the Cleveland Clinic, where, she says, she was put off. Eventually, out of frustration, Bowles staged a topless protest all by herself in June, broadcasting it live on Facebook. First, she headed to the hospital’s office of the CEO, requesting a meeting, and then, when she was escorted out, stood outside of the hospital with a sign bearing images of her botched job as well as others. She was granted a meeting with the Chief Experience Officer that she says has led nowhere; next, she delivered a petition (signed by more than 36,000 supporters) demanding the hospital find a way to hold surgeons accountable for undesirable mastectomy outcomes.

And, Bowles said, she’s not alone in her situation, explaining that since this journey began for her, she’s met “dozens” of other women, in the U.S. and Canada, who have also awakened to find that their wishes to go flat had been denied.

As she noted, “It’s one thing to try to convince a patient” to get reconstruction — a typical situation that’s problematic enough. “But to have a patient say ‘no’ on the operating table, and you still go ahead and do it? That’s malpractice. We are already having cancer treatment. We are vulnerable enough.”

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