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'Boobless Babe' Removes Breasts Despite Not Having Cancer

After testing positive for the BRCA 1 mutation, Stephanie Germino had a double mastectomy and opted to go flat. Now, she advocates for all women to have the choice to do the same.

When Stephanie Germino was 18 years-old, her mother got a preventative double mastectomy and a hysterectomy.

Germino’s grandmother had breast cancer at a very young age, and genetic testing revealed that both her mother and aunt had the BRCA1 mutation — a gene that is associated with a significantly increased risk of breast and ovarian cancer.

“At the time, my mom said, ‘Oh, you'll just deal with this later, it's nothing to worry about,” Germino, who goes by @Theebooblessbabe on social media, tells Healthnews. “I think she was just trying to shield me from worrying and anxiety.”

Throughout her late teens and early twenties, however, Germino did worry. She would often find lumps in her breasts and armpits, repeatedly prompting her to seek medical attention.

Each lump, fortunately, turned out to be a benign fibroid or cyst, and her doctors encouraged her to delay BRCA gene testing until after she was done having children. So at the age of 27 — four years after giving birth to her son — she finally decided to get tested.

Getting the news

Germino knew there was a 50% chance that she would test positive for the inherited gene mutation since her mother had it, and she had always intended to get a preventative double mastectomy and breast mound reconstruction if that turned out to be the case.

She found out she was positive while sitting in the parking lot of her office. The conversation was short, and she didn’t ask many questions — something she now regrets.

“I didn’t know what I didn’t know,” she says.

If she were to do it again today, Germino says she would work with a genetic counselor who could explain all the necessary testing and what questions to ask to ensure she was informed about all her predispositions. “My advice to people is to make sure you get a full panel testing, not just for BRCA,” she says.

@theebooblessbabe Things we wish we knew before a double mastectomy. Check the bio for: Mastectomy Must Haves #doublemastectomy #bodypositivity #fypシ #womenempowerment #confidence #BRCA1 #inverted #Aestheticflatclosure ♬ original sound - Theebooblessbabe

After she received the news, Germino sat in her car for a while to process before calling her fiancé to tell her the news.

“It wasn't devastating for me,” Germino says of finding out her positive result. “It was kind of a relief because for nine years, I had been sitting and wondering about it, and so knowing I was positive gave me the power to actually do something.”

What are the BRCA gene mutations?

A woman who has a BRCA1 or BRCA2 gene mutation has up to a seven in 10 chance of getting breast cancer by age 80, according to Natalie Johnson, M.D., a breast surgical oncologist at City of Hope Orange County Lennar Foundation Cancer Center in Irvine, California.

In addition, Johnson says having one of these gene mutations makes it more likely that a woman will have cancer in both breasts.

“Women who have been diagnosed with a BRCA1 or BRCA2 genetic mutation may make the choice to undergo a preventative mastectomy, which means having both breasts surgically removed, in order to reduce their cancer risk,” Johnson tells Healthnews. “This is a significant and very personal decision that should be made in consultation with a trusted breast surgical oncologist.”

Genetic testing is considered highly accurate, but a negative result can have different meanings, Johnson says. While a negative result means that a woman does not carry a gene mutation that is known to be associated with an increased risk of breast cancer, genetic testing can be uninformative or indeterminate when a woman has a family history of breast or ovarian cancer, and yet she tests negative for any cancer-related gene mutations.

This could mean she has a mutation in a gene that was not tested, or there may be gene mutations that increase the risk of cancer that are yet to be discovered.

Among those with the BRCA1 mutation, the risk of ovarian/fallopian tube cancer is also 40-60%, according to Linnea Chap, M.D., the director of breast cancer and women’s oncology at the Beverly Hills Cancer Center. And because there is no effective screening for these cancers, she says surgery is recommended after childbearing is complete or by the age of 40.

Chap says it’s also important to note that most women who get breast cancer don’t have an inherited gene mutation related to the disease: only about 5-10% of breast cancers are related to a known inherited gene mutation.

However, for those that do have an inherited gene mutation, Chap explains that having a preventative double mastectomy will reduce the risk of breast cancer by at least 90% — a fact that leads most women with a genetic mutation to choose this option.

This is still a painful decision for many women who may feel that having the procedure will somehow make them feel less of a woman. They can experience heightened anxiety about how others will perceive them, what kind of impact it will have on their marriage or other intimate relationships, and how it might impact their self-esteem.

Chap

Choosing aesthetic flat closure

Up until just a few months before her surgery, Germino had intended to get breast mound reconstruction, aka breast implants. She had never really considered any other choice.

But Germino had always been insecure about her breasts. She had struggled with them ever since puberty, feeling self-conscious about how they looked and always comparing her body to others. Still, not having breasts never seemed like a legitimate option.

That is, until Germino and her fiancé met with the breast surgeon for the first time. After the appointment, her partner sat her down and encouraged her to really think through the decision to get implants.

“She said to me, ‘You're getting this risk reducing surgery and putting potential foreign objects into your body that could cause other issues,’” Germino says.

At the time, the couple had several friends who were getting their implants removed because of breast implant illness, which can cause fatigue, memory loss, rash, brain fog, and joint pain. Her fiancé also noted that some implants need to be maintained every 10 years.

The United States Food and Drug Administration (FDA) says breast implants can cause a number of risks and complications in addition to breast implant illness, including breast pain and changes in nipple and breast sensation, the need for multiple surgeries, capsular contracture (scar tissue that forms around the implant and squeezes it), rupture and deflation, breast implant associated-anaplastic large cell lymphoma (a rare type of non-Hodgkin's lymphoma), and squamous cell carcinoma (SCC) and various lymphomas.

Aside from the health risks, Germino also began to think about the appearance of many of the post-double mastectomy reconstructed breasts she’d seen, and she wasn’t sure she liked the look of them without real breast tissue to soften them up.

She also thought about all the insecurities her own breasts had caused her over the years.

“But I didn't know what else was out there, and my surgeon was pushing for some type of mound reconstruction,” she says.

It wasn’t until she was on TikTok and came across a creator called @StatisticalOddity that she realized going flat was a genuine option.

@statisticaloddity Replying to @Ashley| Parenting Mindfully samsies! #mastectomy #breastcancer #bcam #brca #breastcancerawarenessmonth #aestheticflatclosure #nobraday ♬ original sound - Statistical Oddity

“She was the first ever flatty that I had seen and it took me a minute to register what I was seeing,” she says. “I was taken aback, but I was fascinated.”

After learning more about her story, Germino discovered that the creator had received aesthetic flat closure — which is done to rebuild the shape of the chest wall after one or both breasts are removed — after battling multiple cancers. Germino was so fascinated by what she had learned that she brought it up to her surgeon during her next appointment.

He was not for it.

Fighting for her choice

Germino says her surgeon gave her plenty of pushback when she inquired about an aesthetic flat closure, suggesting instead that he do a Goldilocks procedure — when the surgeon removes the breast tissue but leaves the skin in case the person changes their mind and wants breast mound reconstruction after all.

“When I was having to advocate for myself, I was wavering, I was shaking,” she says. “But I knew that I didn't want somebody else to dictate what I did with my body.”

But the surgeon persisted. He questioned Germino’s femininity, asking her why she didn’t want to feel like a woman and pointing to the fact that she’s a lesbian as the obvious explanation for why she wouldn’t want implants.

Society perpetuates that boobs equals normal femininity and once you don't have them — regardless of whether you choose it or you lose them — you're no longer a woman.

Germino

Fighting for what she wanted wasn’t easy, but the resident assisting the doctor with the surgery was a fellow member of the LGBTQ+ community, and she says she was able to be honest with him about what she wanted, and he would listen.

Finally, after much convincing, Germino’s surgeon agreed to the aesthetic flat closure, and in 2021 she underwent her preventative double mastectomy.

“I wasn't always planning to be flat, but I have never regretted my decision,” she says. “I was always confident, but I really didn't come into my own power and my own true self until after the surgery.”

Sharing her story

Germino’s experience hasn’t been easy, but she’s taken all that she’s learned and turned to social media advocacy to help others understand that they, too, have options.

On TikTok and Instagram, Germino encourages preventative testing and raises awareness about the aesthetic flat closure option — showing women that choosing not to have breasts doesn’t make you any less of a woman.

@theebooblessbabe “I’m scared my partner won’t find me attractive anymore” “People will think I’m a man” “Don’t you want to feel like a whole woman?” “You ruined yourself” “Don’t the stares bother you?” “How will you feed your hypothetical future children?” And to all this I say, ALWAYS CHOOSE YOU! Don’t let the what ifs and other people’s opinions dictate how you choose to show up in this world 🫶🏽 What you want is valid and who you are is valid 👏🏽 #fypシ #doublemastectomy #Aestheticflatclosure #bodypositivity #BRCA1 #mastectomy #womenempowerment #lovetheskinyourein ♬ original sound - Theebooblessbabe

“I've heard too many stories similar to mine from people who didn't know that aesthetic flat closure was an option, their doctors didn't tell them, they've had to fight with them, they've had to fight the medical board, all these terrible things,” she says. “And this is why I'm doing what I'm doing — because I want to be that person who made you realize that you have a choice, you have options.”

As with any online content creator, Germino encounters plenty of viewers who don’t understand her message. Oftentimes, people assume that her surgery and choice to go flat were about gender affirmation.

And while she says she wholeheartedly believes that both top surgery and double mastectomies are life-saving surgeries, she reminds her audience that she identifies as a woman, that her surgery had nothing to do with gender identity, and that aesthetic flat closure was simply the option that gave her the greatest peace of mind.

Germino says she also gets backlash about always showing up on social media topless, but she chooses to do so to raise awareness.

“No, I don't live my life topless and I do own shirts,” she jokes. “But I show up like this because it makes you aware and think, ‘Oh I need to get checked,’ or ‘What happened? I'm intrigued.’”

Showing up topless, she says, shows other women they can do what they choose with their own bodies. It shows them that they don’t have to listen to the surgeon who says they’ll be less of a woman without breasts, or the husband who says he’ll no longer be attracted to them if they’re flat — a story Germino says she’s heard a shocking number of times.

Ultimately, says she’s proud to have grown a massive platform that allows her to take an unfortunate experience and turn it into something uplifting and powerful for others in the same situation.

“It's not just about BRCA, it's not just about breast cancer, and it's not just about flat closures,” she says. “It's about being a badass woman who defines her own femininity, defines herself, and doesn't let society tell her what she needs to look like. I want to give a little bit of my confidence to everyone who is seeking it.”

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