Special Post-Mastectomy Issues

Many factors may affect your life after mastectomy surgery. Here's a brief look at some of the more common issues post-mastectomy women face:

  • If you've had a single mastectomy, you'll need to consider the size and shape of your healthy breast when choosing a breast form, to ensure that the two sides will match. So, it's especially important to find a good fitter. Since you'll only have to deal with one form, maintenance and travel will be somewhat easier for you than for women with bilaterals. Also, your bra will be anchored in place by your remaining breast, so it will stay put.

  • If you've had a single mastectomy and your remaining breast is very large, this will present extra challenges. This is particularly true for women with a small band size but an extra-large cup size. However, there are workable solutions. Breast forms are available in lightweight versions that will match up to an H cup. Finding mastectomy bras to use with such large forms is a bit more challenging, but you always have the option of sewing a pocket into your regular bra on the mastectomy side.

  • If you've had a bilateral mastectomy, you can be any size you wish. You can even vary the size of your breast forms, perhaps wearing smaller ones most of the time, but larger ones when dressing up. It may take some experimentation to figure out how high on your chest to wear your breast forms. Also, you may worry that your bras will ride up. Fortunately, most women find that their bras stay in place just fine, once they've adjusted the hooks and straps to the desired fit. If you prefer to go flat after surgery, that's easy to do with a bilateral, since you have symmetry. Some women find going flat the ultimate comfortable solution.

  • If you're a plus-size woman who's had a bilateral mastectomy, you'll have different issues than slim women. Slim women can wear small breast forms and look in proportion. Especially with silicone forms, the smaller the form, the lighter the weight. So, as a larger woman, you'll face more challenges finding comfortable breast forms that suit your frame.

  • If you develop lymphedema, you'll encounter special difficulties. Especially if you have truncal lymphedema, you'll need to find breast forms and bras that won't worsen the problem. Lymphedema therapists can help you learn to control the lymphedema. There is a website, Step Up, Speak Out, which provides resources, support, and advocacy for those with breast-cancer-related lymphedema. Also, check out Binney's Story to learn more about lymphedema after mastectomy.

  • Sometimes after a mastectomy women wind up with dog ears under their arms. Dog ears, which are pockets of fatty tissue remaining after surgery, are particularly common in overweight women or those who have large breasts. But they can happen to anyone, especially a smaller type of dog ear, where skin and fat at the end of an incision may form a slight pucker or bulge. Even if you ask your surgeon to make you as smooth and flat as possible, this is difficult to achieve for some surgeons. If you end up with dog ears, the good news is that it's possible to have a "revision" surgery to remove them. This is usually performed by a plastic surgeon and is a relatively minor procedure, often done on an outpatient basis. Most women who have revisions are very happy with the results. If you're concerned about dog ears, check out these Before and After photos of dog ear revision surgery.

  • Everyone heals differently. Although you'll probably feel quite good after four weeks, your surgery site will continue healing for several months. Subtle changes may continue for a year and beyond. You may regain all the feeling in your chest or some numbness may remain. Swelling and fluid can linger for quite a while, which will affect how bras fit you and how breast forms feel. Regenerating nerves may cause temporary sensitivity. You may be uncomfortable having silicone next to your skin or it may not bother you at all. If you've had radiation, that may affect how your skin reacts to breast forms and bras. It's important to bear in mind that adjusting to life breast-free is a process of trial and error. It may take a while to find the right solutions for you. The options discussed in the sections on Breast Forms, as well as Bras, Camisoles, and Swimsuits and Going Flat are designed to help in this process.