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Dressing After a Mastectomy

Posted 5/15/2015

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  Although there are plenty of surgeries that are physically more difficult than a simple mastectomy (talking her about a mastectomy without reconstruction; reconstruction surely makes it tougher), there may be none that have more psychological import or immediate logistical issues. Losing a breast is a very big deal and deciding how to present yourself to the public can be challenging. Again, I am mainly thinking here about women who opt for no reconstruction or, to some extent, who choose reconstruction with an expander so that their chest is quite flat in the early days.

  My first psychological advice is to look at yourself as soon as possible, ideally while you are still in the hospital. Waiting does not soften the shock, and may even increase the tension and distress. Look at yourself and touch yourself when you can. As soon as the bandages are off (and it is often surprising that there are hardly any bandages, sometimes just a steri strip or two), start soaping yourself in the shower and, when healing begins, applying lotion after you are dry.

If you have a partner, my advice is to involve him/her in these ministrations. I have known a few women whose husbands had not seen their chests several years post surgery. They have been careful to dress alone and to always wear some kind of top to bed. Clearly, if this is their choice and they are comfortable with it, I support it--but it surely feels hard and a set up for unease or even shame.

There is a very wonderful website with all kinds of advice and pictures:

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. Big shirts or sweaters that open down the front will work best as raising your arms above your head may be hard in the first days.

Most women are ready for a breast prosthesis approximately one month after mastectomy. We work closely with New England Medical Fitting Service. You can call them at 781 340-1515 to make an appointment at their store in Weymouth or at the Windows of Hope Shop at BIDMC. They can also help you with bras. Since I am always looking for the humor in bad situations, here it is: most insurances will cover the cost of several (number varies) mastectomy bras each year. I find it pretty hilarious that Harvard Pilgrim is now buying my lingerie.

Lady Grace has a number of stores in the Boston area that fit and sell breast prostheses and mastectomy bras.

There are also prostheses that are custom made from a carefully casted 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 often 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. You can, of course, consider a genuine tattoo, and I can recommend a wonderful Boston-area tattoo artist. I know several women who have done this and reported that there was little pain as most of your nerves are gone. One small plus to the whole pretty horrible situation.

Here is the promise: you will adapt and the days will come, soon than you expect, that you will barely think about your changed body.


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