Breast Prostheses, Bras & More

Breast Prostheses, Bras & More  Preparing for a fitting  

Managing Scar Tissue Nipple Tattooing

 Caring for Your Skin  Body Image

BREAST PROSTHESES, BRAS & MORE

Is there a ‘Right’ Thing to Wear after Surgery or During Radiation?

Whether you are still unsure what course of action to take, or you are post-op, there are a lot of ways to feel more comfortable and like you. 

LET’S CHECK IN…

It’s possible you’re feeling a mix of different emotions after a mastectomy or lumpectomy. As your body continues to change, your relationship with your body may as well. It is important to know that it is recommended to wait six to eight weeks before you start shopping for new bras or breast forms, as swelling can affect the fit and comfort.

RIGHT AFTER BREAST CANCER SURGERY & DURING RADIATION TREATMENT

 For the first four to six weeks, it is best to opt for: compression-free & wire-free bras and camisoles.

Compression and wire-free bras are often made from soft fabrics and known as ‘leisure bras.’ When shopping for a leisure bra online or in-person, look for something that closes in the front rather than the back. After a mastectomy your body is still in recovery, and it can be difficult to pull anything over your head or reach behind to clasp the bra. If it is possible to try the garment on, ensure that the bra fits comfortably on the loosest hook. This is so it can be worn looser to begin with and gradually tightened as the swelling goes down. 

Some women also require drainage tubes following surgery. There are special camisoles with pouches or pockets or special bras you can attach pouches to keep the tubes in place.  You can also sew pockets inside a shirt.  A stretchy and comfortable tube top can also be comfortable, just make sure you can get it on by pulling it up over your hips rather than over your head.   A light, fiberfill breast form (also called an initial breast form) can be worn in a bra or camisole if you so choose. Some initial breast forms allow you to adjust the amount of fill inside to match the size of your other breast if you had a single mastectomy

While garments with a pocket specifically to hold breast forms will be the most secure, the choice of what you wear is up to you.

WHAT IF I AM HAVING A LUMPECTOMY?

Follow the information above, however it is good to keep in mind that your medical team may advise you to wear a bra for 24-hours a day for the first week or two after surgery.  Like with a mastectomy, look for a bra with:

• soft fabric

• no compression

• no underwire

• easy to put on.

BUT RADIATION IS PART OF MY CARE PLAN!

Like dressing for a mastectomy and lumpectomy, look for:

• soft fabric

• underwire free

• no compression.

• ideally something that does up at the front 

Avoid:

• anything with seams that may rub against your radiation site. 

Fitted, not tight, tank tops made from bamboo cotton offer support and are a great option for many women. While others prefer loose-fitting button up shirts and go without a bra or camisole. What works best for you might come with some trial and error, but having a few different options will be helpful, especially if you need to wash them often because of regular use of creams and ointments on the treatment site.

I HAD RECONSTRUCTION. WHAT ABOUT ME?

Compression bras will be your friend here! A compression bra following reconstruction helps to maintain shape and holds the breast(s) in place, preventing pressure points and tissue irritation from forming.

It is great to look for a compression bra made from:

• strong fabric
• no seams on the skin
• and a longer line for comfort  

Again, a front closure means you won’t have to stretch to reach a back closure or pull anything over your head. Your body will thank you!

GOOD TO KNOW

Lymphedema: People who are treated for cancer are at risk for lymphedema if they have lymph nodes or vessels removed or damaged during treatment. Speak with your doctor about treatment options and visit canadalymph.ca for more information. 

POST-RECOVERY

When you are ready to move into an everyday bra, which can range from two months to one year after treatment is complete, special mastectomy bras are available in styles ranging from lingerie, sport and everyday bras. These are specific for post-mastectomy or post- lumpectomy because they come with pockets to hold breast forms.  Many have a higher neckline for support and to help cover scars. If you sew, or know someone who can, you can have pockets sewn into any bra as well – but you may need to experiment a bit to get the right design to hold the breast form. 

Remember that your size and shape may have changed post-treatment and post-surgery.  A specialized bra retailer can help you find the right size – or check out our bra-fitting tips below.

CURIOUS ABOUT BREAST FORMS & GARMENTS?

BREAST FORMS

Have you heard the term breast form or breast prosthesis before? Whatever the   name, they are a product designed to mimic the shape of a breast for women who have   had a mastectomy or lumpectomy. Some breasts forms even have a similar feel to a natural breast.

Breast forms are inserted into special pockets in bras to help clothes fit better. Many women wear them to restore balance and   help boost confidence in their new body. There is nothing wrong with wanting to feel like yourself. Some women use breast forms while waiting for reconstruction, others may choose to not have reconstruction and use forms as a long-term option. You may find you wear a breast form all the time, or just on certain days or during certain activities. Some women find wearing a breast form helps minimize shoulder droop and others choose to not wear one at all and “live flat.”

There are many different options, but no universal ‘right’ choice, the right choice is what works best for YOU and your needs!

Should you choose to wear a breast form, there are lots of different options out there. They vary in weight, material, size and shape, so you want to take the time to try them out and find the best one for you.   Some are even made specially for exercising and swimming.  Custom made breast forms are also available if you aren`t able to find a shape off the shelf that works for you.   

BREAST FORMS COME IN MANY OPTIONS:

• Various weights to match natural breast or lightweight
• Some companies offer forms in up to 3 different shades
• Partial forms available for lumpectomy
• Symmetrical or Asymmetrical to match your natural shape
• Special forms for swimming or sports
• Forms are made of different materials including silicone, gel, fiber fill, foam

During the 6-week healing period, you won’t want to add weight or compression to the area. Initial breast forms, which are made of a lightweight, loose fibre, are a good option. Some initial breast forms allow you to adjust the amount of fill inside to match the size of your other breast if you had a single mastectomy. If you are having reconstruction later, you can add fill back in if you are going to have an expander.  Some women like the lightweight fibre of an initial breast form and choose this option as their standard breast form after the recovery period has passed.  Others prefer the weight of a standard breast form as it can feel more what they are used to.  Some women refer to the “hug test” – or what makes them feel most comfortable when hugging a loved on.  Knowing what will work for you will depend on your needs. No one knows you better than you!

 

PARTIAL FORMS:

• Used after lumpectomy, lymph node removal;

• Can also be used several years after a reconstruction to match changes in your other breast due to  changes in weight  and natural changes over time,

• They help balance shape and create symmetry,

• Options for every shape and size to match the other breast.

PREPARING FOR A FITTING

• Schedule 6+ weeks after surgery.

• Ensure you don’t have any swelling to find a proper fit.

• No drainage at site.

• Must be completely healed: no wounds or bandages.

• Most fittings are more than an hour - call and book an appointment.

• Bring a fitted t-shirt to try on over top of bra.

Nervous about going in? Call ahead to ask questions and see if you feel comfortable and ready to book your appointment. Does the retailer appear to be knowledgeable of various surgery types and treatment?  Ask if they carry a range of products and if they have a private atmosphere. Your comfort is key here! 

BRA FITTING TIPS

Did you know that many women are not wearing the right size bra?  When our bras don’t fit right, we may have pain where straps dig in, feel uncomfortable if the back rides up, or self-conscious in our clothes. 

The band in the most important measurement as it provides 80% of the support. It should be parallel to the ground all the way around.  If the back is riding up, go down a band size.

If your breast is spilling out over the top of the cup, or the bra is digging into the breast, go up a cup size. If there is extra cup fabric, go down a cup size. Don’t try to make up for a poorly fit band or the wrong cup size by adjusting the straps – you’ll end up with less support and may hurt your shoulders. The straps should sit comfortably and not create any red marks. 

Remember, just like breasts, bras come in different shapes and styles. So, make sure to try a few on to find the one that works best for you.  

FIND A RETAILER IN YOUR COMMUNITY

There are many retailers across Canada which carry breast care products.  Consider asking for recommendations from your cancer care centre, friends or family members, or try doing an internet search to locate the nearest in your neighbourhood.  Remember to call ahead to book an appointment and ask questions.  

Questions like:

• Do they have a private fitting room with a full-length mirror? 

• Do they offer a range of products you can try? 

• Can you book an appointment during a quiet time in the store?

Look Good Feel Better thanks Anita Canada for their commitment to the Breast Care, Forms and Garments  workshop. You can learn more about Anita Canada and their retail partners here.

FINANCIAL COVERAGE

The average post-mastectomy bra is under $100, a prosthesis is $200 to $400. Depending on where you live, your provincial healthcare plan may reimburse some costs of breast prostheses. For private health insurance, it depends on the plan, but they often will cover prostheses as well as post-operative bras once per year. Additional information about provincial funding for breast prostheses, click here. 

Check out our community resource page for free resources in your community or visit the CCS Service Locator for a comprehensive listing. Talk to your team at your cancer centre for more free resources.

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FEELING LIKE YOURSELF POST-TREATMENT: MANAGING SCAR TISSUE

Feeling more like yourself is important. That can be difficult if you are managing with scar tissue. Luckily, there are many things that can be done to feel more comfortable in the skin you are in.

Comfort is important for enhancing quality of life. It can be discouraging to still feel pain, swelling, tightness, sensitivity or a restricted range of motion after completing breast cancer treatment. For some women, discomfort may last far past their expected recovery time from surgery or radiation. If you have done the exercises your doctor recommended and still don’t feel comfortable, make sure you tell your care team. 

The reason for prolonged discomfort may be a build-up of scar tissue inside the body, typically around the breast, chest or shoulder area. Scaring can cause the surrounding tissue to become denser and less elastic and result in restricted movement and/or pain. Some women describe it as feeling “sticky” or “like Velcro” when they try moving the affected area.

So, what can you do to feel more at ease? 

You may want to consider adding a physiotherapist or massage therapist who specializes in caring for breast cancer patients to your care team. Speaking with your primary care team about your concern is a great first step if you haven’t yet. And if you find resistance when the subject is brought up, don’t forget you can always always advocate for yourself, or ask your loved ones or support person to help too. 

Physiotherapy or massage therapy is done on the chest, breast and/or shoulders to loosen and soften tissue.  Your provider may suggest techniques such as myofascial release, deep friction massage or cupping therapy.   When these techniques are applied and followed by stretches, they can help break up rigid tissue and relax tension that can cause pain and restrict movement. 

Who can you go to for help?

• Typically, it will be a physiotherapist or massage therapist who will have specialized expertise and experience working with breast cancer patients

• Refer to the Society for Oncology Massage and Canadian Physiotherapy Association to learn more and access a directory.  Your provincial Lymphedema Association can also be a great resource for therapists familiar with breast-cancer related side effects.

• Some healthcare professionals use the term Cancer Rehabilitation to refer to their services that help manage the common side effects of cancer and cancer treatment.  This can be a great search term when looking for professionals in your area!

Questions to ask:

• Are you a licensed Healthcare provider registered with the provincial college?

• Are you experienced in treating breast cancer patients?

• Do you provide techniques I can do at home?

Good to Know:

• Talk to your surgeon or oncologist to ensure this is right for you and enough recovery time has passed

• Treatment of lymphedema requires a qualified and certified practitioner, access a directory at https://canadalymph.ca/certified-lymphedema-therapists/

• It is important to know that most of these services are not covered under provincial healthcare plans. But it is best to ask your healthcare team.

• If you have extended healthcare benefits through your school or work, make sure to check with them as well.

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NIPPLE TATTOOING: AREOLA RESTORATION AFTER BREAST CANCER SURGERY

Have you been curious about areola restoration? Don’t worry, you’re not the only one, many women consider nipple tattooing as part of their breast cancer journey!

Is areola restoration, also known as nipple tattooing, right for you? Nipple tattooing uses ink and shading techniques like traditional tattooing; this gives the illusion of 3D nipples where there may be none. For many women, investing the time and money into the process following breast cancer surgery provides a sense of confidence, empowerment, and comfort. Whether you choose to include this in your post-cancer journey or not is entirely up to you, however, there are a few things to consider before you choose!

Is there a ‘Right Type’ of Breast Tissue?

The first important thing to know is that nipple tattoos can be done on any type of tissue:

• reconstructed breast, with or without implants

• reconstructed nipples

• chest wall after a mastectomy

It is best to make sure you wait at least one year after all your treatments are completed before getting a tattoo.  It may seem like a long time to wait, but if you end up needing any follow up procedures, they could impact the tattoo.

Decorative Tattoos, also known as mastectomy tattoo, is a form of body art that can be used to cover or camouflage scars. Many women who choose this find it to be an empowering form of self-expression and an opportunity to redefine one’s experience after breast cancer surgery. A wait time of at least one year after all treatment is complete is recommended before having any decorative tattooing. Decorative Tattoos may be done alone or in addition to areola restoration tattooing. Some technicians do both decorative and restoration tattoos, other specialize in one or the other.

Who do I go to for Nipple Tattooing?

Choosing the right technician for a nipple tattoo is important as it takes time and money, is permanent, and requires you to be comfortable with the person. There is no ‘perfect’ technician as everyone’s needs are different and varying. So, choosing the technician who is right for you is worth spending some time on.  If you are feeling overwhelmed, ask a trusted friend to help you make calls and pre-screen with you. You might also want to speak to your doctor, medical team, or other women for references too.  

Here are the top areas to consider:

1. Safety – choose a place registered with your local public health unit:

• Tattooing is not regulated under Federal or Provincial governments.  Establishments, however, can register with public health and will be inspected and regulated.

• Public health regulations will include standards on things like hand washing, sterilization, single-use needles, and bagging of machines to prevent the risk of infection.  

2. Artistry & Technique:

• Ensuring that the colour, design and shading is skillfully planned and executed will help create a realistic areola tattoo. These factors should be customized for you to match an existing nipple, replicate what you are used to or align with your personal preferences.  Colour, shape, size is unique to each woman.

• Like with art, colour theory is a vital component of tattooing.  It’s extremely important that the technician you select is experienced and knowledgeable on the role of skin tones and undertones as well as how they will impact the way colour pigments show up on you.

• Before finalizing an areola design on your body, ensure the technician can draw it on paper first.  This will show whether they have the artistic skills to deliver on the design you have selected.

• Proper technique will ensure the colour pigment stays vibrant as the skin heals and tattoo develops. Stretching of the skin as the needle is tattooing will also help achieve this and ensure the ink does not fade. 

• Other things to look for include: no patchiness, clean line work and smooth shading.

Colour and camouflaging scars:  Tattooing can cover a scar that is light by making it darker, but it is very difficult to make a scar that is dark, lighter.  Laser therapy may help in lightning scars and should be considered if lighting is needed before embarking on tattooing.

3. Empathy

• Your needs are important during this experience. Ensure you feel comfortable with your technician.  A technician should be patient throughout the process from deciding on a design to respecting your needs for breaks while getting the tattoo. Speaking up if you are uncomfortable provides a better experience for you, and also ensures the technician is tuned into your needs.

Good to Know

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CARING FOR THE SKIN YOU'RE IN

Taking care of you doesn’t stop with cancer. Follow these easy tips to show love to the skin you are in.

Starting A  Routine:

Starting a skincare routine before radiation will give your skin a boost and is a great opportunity to practice self care. Follow these simple steps:

Here are some easy-to-follow tips to help your skin during treatment:

• Keep showers or baths short and use lukewarm water, avoid extreme temperatures

• Continue using gentle, fragrance free and ph-balancing products daily to cleanse and moisturize

• Your skin will be extra-sensitive to the sun so keep the area protected.  Cover the treated area with sun-protective clothing or items you cannot see through when you hold them up to the light.  If you can’t cover the area, ask your care team about sunscreen options.

• Don’t rub, massage or scratch the treatment area

  • avoid using facecloths as they may cause friction

  • use a soft towel to pat skin just enough to remove water – don’t rub completely dry

• Prevent rubbing and friction by wearing loose-fitting clothing, ideally cotton or other soft, breathable fabrics
• Do not shave or use hair removal creams on the treatment area
• Consider products with thermal water, which have been shown to reduce radiation’s negative impacts on the skin

Keep areas under your breast dry to avoid fungal infections in the folds.  Cornstarch (not talcum powder) or an antifungal powder can help manage itchiness and redness.

Managing and Caring for Scaring 

Before Surgery

If you are prone to keloids, ask your surgeon how this can be best managed with medication, topical treatments or strategic scar placement. It is okay to be concerned about scarring and to advocate for yourself. 

After Surgery:

Wait at least one year after all treatments are done before getting any nipple or decorative tattoos should you choose.  Read more here about nipple tattooing here. 

• Follow care instructions from your surgeon to keeping the surgical site clean

• Once approved by your surgeon, usually about one month after surgery, you can start massaging the scar using either a cooking oil or scar reducing oil

• Silicone scar sheets can help improve healing

•  

• Don’t wear clothing that compresses the scar for at least 4-6 weeks after surgery.  If that makes wearing a regular bra difficult, try a tube top, tank top or leisure bra to provide support if needed

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BODY OF WORK

For many women living with cancer or in remission, changes in her appearance can be a major source  of concern and anxiety.  This is not vanity.  Much of our identity is related to our physical appearance from how we wear our hair to what clothes we choose to wear.  Body shape and size, including  breasts, are often tied to a woman’s sense of self, self-expression, sexuality, and self-esteem. 

Appearance-related impacts of cancer can be temporary (like hair loss and skin changes) or more permanent (like surgery or scarring). They can all affect women at a time when they may already feel vulnerable, which can negatively impact their mental and emotional health. 

For many women facing a cancer diagnosis, there's enough to cope with emotionally without also feeling that there's no space to speak about body image issues or that it is somehow selfish or vain to worry about them. For Dee-Jay Jodoin, a B.C. woman in remission, changes to her physical appearance like hair loss and weight gain were hard to accept. “It [cancer treatment] alters your appearance. You want to get back to the way you were, but it takes time. When guys lose their hair it’s “well they’re just men” but it’s different for women.”

THE PHYSICAL & EMOTIONAL CONNECTION

“Women going through cancer treatment often experience a change in their body image and in their relationship with their body,” says Monique Voorn, a social worker at the Simcoe Muskoka Regional Cancer Centre in Barrie, Ontario. “They may be unhappy about how their appearance has changed, whether they’ve had breast surgery or scars they don’t like, or lymphedema. Sometimes, a woman may not have had significant visual changes to her body but feels like her body has failed her or that she can’t count on it.”

There can also be physical changes that women may not expect. “With radiation, there are skin changes,” notes Larissa Dyck, an oncology nurse in Calgary, Alta. “The area that’s treated can end up darker and may take a while to fade, and skin can get tighter and be uncomfortable for some patients, causing a loss of range of motion. Keloids - a type of raised scar that can arise after a surgery — can be a particular concern for Black women specifically.

Weight can be an issue, too. Being on hormones can cause weight changes that can turn women’s body image completely upside down and they can get really down on themselves.” 

It takes time for women to recognize and appreciate the full impact of the changes they’ve undergone during their cancer journey. “It’s often near the end of treatment when it really hits women what they’ve been through and all the changes they’ve undergone – physical and otherwise,” says Dyck. “When patients are finished their treatment, they expect things to go back to normal — but they may still be on long-term hormones or medication, and that’s when it can be really hard for these women. They expect their bodies to just bounce back, and they want to go back to work and exercise, but things aren’t the same as before.” 

EMPOWERMENT IS DIFFERENT FOR EVERY WOMAN

While physical symptoms can affect women in a finite number of ways, the emotional experience is different for everyone. “When some women lose their hair with chemo, they’ll proudly wear a head scarf,” says Dyck. “Other women have a complete loss of identity and want to wear a wig. They may fear that their partners won’t be attracted to them.” 

Social worker, Monique Voon agrees, “There’s a wave or rollercoaster ride of emotions in any type of cancer. There’s a lot of grief. We grieve all kinds of changes or losses in our lives that cancer brings — to your body, to your innocence, and to the carefree way that you may have used to experience life.”

Every woman’s experience, perspective and cancer journey are unique. They want to be listened to as individuals, and they don’t want assumptions to be made about how they feel about their body. Allowing and accepting different experiences, reactions, and stages of grieving is part of the process. Every decision – from choosing a wig versus scarf, or breast reconstruction versus breast forms or living flat – is personal and empowering to each woman. 

With the right tools and support, women can gain confidence in their ability to restore or renew their sense of self   — however they may choose to define it.  

There are many programs offering practical and emotional support, as well as individual options.  Share your concerns with your medical team and ask for help.  Check out your hospital’s resource library or check out the many online options.

EVERY DAY WE HELP WOMEN FEEL LIKE THEMSELVES AGAIN 

At a Look Good Feel Better workshop, women with cancer can learn how to manage the appearance-related impact of cancer and its treat­ment in a small and supportive group

Skincare & Cosmetics: Learn how to care for sensitive skin plus tips & techniques for managing the loss of brows and lashes, adding colour back to the face, makeup hygiene and sun safety.

Breast Care Forms, Bras & Garments: Learn about options available for post-surgery and beyond, what to expect at a breast form fitting, tips for where to find financial coverage, and more.

Wigs & Hair Alternatives: See a demonstration on various head coverings, what to consider when selecting a wig, easy scarf-tying techniques, plus caring for your scalp during and after treatment.

Teens: This special workshop just for teens includes skincare, on-trend make-up tips to feel your best and a demonstration of fun styles for caps, wraps and hair alternatives.

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BREAST CARE PROGRAM IN PARTNERSHIP WITH ANITA CANADA

We hope the steps outlined here will help you find ways to manage the appearance-related effects of cancer treatment.

These steps are not intended to replace medical care in any way. These steps are meant to support the advice from your healthcare team. You should always consult your healthcare practitioner with any questions or concerns.

Many retailers in Canada sell breast care products. Consider asking your cancer center, friends or family members for recommendations, or do an internet search to find the one closest to you. Don't forget to call ahead to make an appointment and ask your questions. Do they have a private dressing room with a full length mirror? Do they offer a range of products you can try? Do they seem knowledgeable? Can you make an appointment during a quieter time for the store?

Look Good Feel Better thanks Anita Canada for their commitment to the breast care segment of our workshop. You can learn more about Anita Canada and its retail partners here .

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