Lingerie, a pleasure in good times, can become overwhelming in really bad times. You need specialist help in deciding on the best lingerie for you, particularly if you have had breast surgery.
Anita, a German company, is the biggest supplier of post-operative and mastectomy lingerie to the UK. They provide training to their stockists and very kindly invited to me to one of their training days. Their advice for those living with and beyond breast cancer is as follows.
There is a selection of bras that will help keep you comfortable and well supported after surgery. Some of these post-operative bras are designed specifically for where reconstruction has taken place and feature compression for wound healing; others have seam-free interiors and soft touch for those undergoing radiotherapy. A third type of bra has soft front fastening and is pocketed. The pockets hold a soft breast form and help support the remaining breast during the healing process. Approximately three months after surgery, the move to pocketed bras for all occasions can be made.
The consultation process is key when recommending a pocketed bra for a post- surgery customer. After the scarring has healed, there are many products that would not be comfortable; some could even create complications.
Most surgeons recommend that a non-wired bra should be worn. Bras without an underwire are more comfortable and reduce the risk of future complications.
However, post-surgery bras are not simply non- wired bras with a pocket – there is much more to consider, not least the risk of lymphoedema (a fluid retention that causes a swelling to the arm).
The risk of lymphoedema is higher in ladies who have had lymph nodes removed as part of their surgery. Where this is the case, not only should the bra be non-wired but it should also be free of any side stiffeners sewn into the underarm area. Ideally the bra should be seam free or have a covered seam in the underarm area.
The most important things to look for in a post-surgery bra are the following:
- Soft fabric
- Deeper than average underarm bands (for comfort over scar tissue)
- Deeper centre cores (for separation of the breast/breast form)
- Higher décolleté, for coverage and containment of the breast form and to prevent it from moving around
- A defined underband to anchor the bra and give comfort without too much pressure
- Broad/padded straps for comfort and prevention of lymphoedema
Sue Pringle has been through treatment for cancer twice: she has had two lumpectomies, a mastectomy, a reconstruction and two menopauses. Sue is on a mission to create a better bra. Her quest stems from her own experiences, conversations and research. Sue found that bra buying escalates soon after surgery:
‘You will probably find that you need to buy more bras than usual in the period immediately following your surgery. Your breast size may continue to fluctuate for up to a year, depending on your subsequent treatment. The swelling caused by lumpectomy surgery can last for up to three months, and radiotherapy can cause fluctuations in breast size for a year or so. It’s also worth considering possible weight gain.’
- Sue Pringle
A mastectomy bra is different from a post- surgery bra. It looks like any other bra but contains cup linings or pockets to contain a breast prosthesis (an artificial breast form that replaces the shape of all or part of the breast that has been removed).
Sue Pringle tells us more about prostheses:
‘A high proportion of women in the UK elect for what is referred to as “breast conserving surgery” or lumpectomy. The breast(s) are reduced in size and shape. There are lots of ways to recreate a more even-looking contour and shape by combining a well-fitting bra with a prosthesis.'
‘Most NHS breast clinics offer a free prosthesis- fitting service, usually run by a specially trained member of the nursing team. The timing of the fitting varies between health authorities. This can make a difference to the shape you achieve and the bra that will work best for you. Ask about the service when you make your clinic visit after surgery. I wasn’t told and made do with uneven-looking breasts when'
‘Prepare yourself for more frequent replacement of your bras as your needs change.’
'I needn’t have.'
‘There is a wide range of shapes, sizes and skin tones available, so it’s relatively easy to find a prosthesis that’s right for you. Most are worn by inserting into a pocketed bra. There are also “sticky” prostheses that are worn directly against the chest wall, making it easier to wear a standard bra. A word of caution – they can become quite hot and very sticky during the summer months, but do give you more bra choices.
‘“Softie” prostheses are designed to be worn soon after surgery. As their name suggests, they are softer and more comfortable to wear while things settle down; they can also be worn if only a little extra fullness is required. Softies designed for swimming are also available. As an NHS patient, every woman is entitled to one prosthesis (excluding first softies); after that it’s more common to pay for one.’
Using the right bra after a double mastectomy and reconstruction is crucial to recovery: it will help the healing process by stabilising the breasts and minimising movement.
‘It’s time for another bra when you feel that you aren’t as supported as you were. Perhaps your body shape has changed or your bra has stretched.’
- German company Anita
Movement prevents the wound closing up and results in slower healing; this, in turn, can increase the risk of scarring and infection, and the final breast positions may not be level or balanced.
Surgeons and specialists recommend a compression bra. The controlled and directional compression offers the breasts strong support in the areas where it is needed, and yet the bra is soft and comfortable against the skin and the pressure points that remain sensitive after surgery.
Compression bras are generally front fastening to minimise stretching and to allow ease of putting on; they also feature soft, wide and Velcro-adjustable straps for convenience.
Often compression bras come with the option of a ‘belt’, which is only used in cases where a silicone or saline implant has been used for the reconstruction. If these implants are not held in place with a belt until they have bedded into the breast and stabilised into a permanent position, they will move as the body moves.
Compression bras, more than anything, ‘take the strain’, allowing the woman to relax in her natural posture and not hold herself in order to protect her wound or to be comfortable.
I am always amazed that women even attempt to choose and fit their own bras. Don’t do it! Go to a specialist and be fitted. Specialist retailers will always have more stock than a general high-street store, and the fitters are likely to be more experienced. They will also be able to help you with a breast prosthesis, should it be appropriate. Often it was the circumstances of these specialist retailers themselves having breast cancer and being unable to find suitable bras and good advice that motivated them to start their own businesses.
Sue Pringle recommends that your bra fit be checked every three months immediately after surgery and every six months after that, but more frequently if there is any significant change in weight.