Dressing after a mastectomy

This is a topic that I have written about before, but it assumes even greater importance every year as summer nears. During the winter, it is easy to wear layers and disguise a flat chest with a big sweater or a jacket. Similarly, women who have lost their hair from chemotherapy often find it simpler to cope in colder weather. Lots of people wear hats all winter, but many fewer do so in hot weather. Even standard baseball hats have a hole in the back, and it is easy to spot a bald head. (note: there are baseball hats available that do not have that opening in the back). Wigs are hot in the summer, and it is much harder to be cool and comfortable in July.

One of the worries for women soon after a mastectomy is clothes. Women who have had reconstruction have fewer concerns, but they, too, may have scars to cover or feel different in their changed bodies. What can I wear? What will make me look normal and feel pretty? What is both comfortable and attractive? This includes thinking both about bras and prostheses and about clothes in general.

A particular summer concern is bathing suits. Most of us who are past our 20s have some concerns anyway about bathing suits, but this is another level of worry. Most stores that carry prostheses or breast cancer-related supplies have bathing suits. You may be surprised to learn that Land's End has many in their catalog. It is also possible to sew a pocket for a prosthesis into any bathing suit. Some women prefer to wear a loose t-shirt over their suit and/or keep a towel in easy reach at the side of the pool.

Immediately after your surgery, you will be most comfortable wearing a soft cotton camisole. There are special camisoles that include a removable pocket for any surgical drains. They also have built in bras (like those in some bathing suits) that can hold a cotton puff. There are various jackets available that have pockets for drains and/or velcro strips that enable you to move the drains around. Ask your surgeon's office or at BIDMC's shop Windows of Hope about these options. About those drains: they need to stay in until your body is draining less than X amount of fluid daily. This takes a variable amount of time, anything from ten days to several weeks. You will be in close touch with your surgeon's office during this period and should not hesitate to call with concerns or question. When you choose clothes in the first days, choose loose and large tops that button down the front. Lifting your arms over your head may be uncomfortable or even impossible at the start.

Women who had reconstruction have a different set of concerns as they heal. If you have chosen to have implants with expanders, you will be dealing with a changing body for some months. If you chose not to have reconstruction, you will be wondering what you can wear now. Most women are ready for a breast prosthesis approximately one month after mastectomy. You have to wait until you are mostly healed, more for reasons of comfort than anything else. Any shop that sells prostheses can also help with bras. Try looking online for post-mastectomy lingerie; you will be pleasantly surprised by what is available.

If you have had a mastectomy without reconstruction, you may need to make some changes to your wardrobe. Most women have a small concave area on their chest above where the breast itself used to be. Remember that breast tissue goes quite a ways up your chest. If you don't care if others see it, no problem. If you do care, you may need to stop wearing low cut tops. There are camisoles and mastectomy bras that include a strip of lace or something pretty along the top; this can solve the problem.

It is important to be professionally fitted for a prosthesis and for comfortable bras. One whimsical option is a knit prosthesis; you probably would not want this to be your only choice, but it can be kind of fun to have a purple sparkly or feather-decorated breast. If you don't know how to knit, this would be a good project for a friend who wants to do something to help.

There are also prostheses that are custom made from a carefully casted model or a computer-generated model of your chest wall. Approximately six months after surgery, you could consider this option. This prosthesis does not have to be worn with a special bra and can even be adhered to your chest and worn without a bra. Although expensive, they are sometimes covered by insurance.

You may choose not to wear prosthesis at all. Wearing loose sweaters, jackets, or scarves draped around your neck and shoulders can disguise a flat chest. Some women feel comfortable not wearing a bra and not trying to cover their loss. This can work especially well if you had bilateral mastectomies.

If you don't like how your scar looks, consider covering it with a temporary tattoo. These generally last about two weeks, but can be washed off with baby oil at any time.

Developed by one of our patients who had bilateral mastectomies without reconstruction, BreastFree.org is a terrific website that covers all of this in much more detail.

Whatever your choice, remember this: You are the same woman you have always been. Just braver and wiser and even more beautiful.