About Reconstruction

What is reconstruction?
Breast reconstruction is a type of surgery that rebuilds the breast mound so that it is approximately the same size and shape as it was before. Some women may choose to have this surgery following a mastectomy. It can be preformed at the same time as your mastectomy or at a later date.

There are different types of breast reconstruction and the best method for you will depend on several factors. Some factors to consider when determining which is best for you is the size/shape of your breasts, whether one or both breasts have been removed, the amount and location of body tissue to be used (abdomen, buttock, thigh), and whether you have had, or will have, radiation treatment.

The 3 main types of reconstruction are:
1) Reconstruction using an implant
2) Reconstruction using your own tissue (Autologous Reconstruction)
3) Reconstruction using your own tissue combined with an implant (Latissimus Reconstruction)

What can I wear immediately after my reconstructive surgery?
It is suggested that you wear a compression bra after reconstruction. This will keep your breasts secure and comfortable while you are healing. It is specially designed to stabilize breast tissue during the healing process and maintain the natural shape of the operated breast after surgery. The skin-friendly and soft cotton material allows for comfort while you are healing. Velcro straps allow for individual strap adjustment and easy access to bandages or for dressing should arm mobility be restricted post-surgery. The Velcro will not bulge underneath clothing. Seamless, molded cups provide an even distribution of compression across the chest. Side panels are built with anatomical seams to support proper shape and fit. A wide band provides comfort where incisions often sit after surgery, the width will ensure your comfort by avoiding digging or rubbing to this sensitive area.

The compression belt (sold separately) helps to keep breast implant(s) from migrating upwards in the chest during the healing process, thereby maintaining a natural breast shape post-surgery.

More information, including pictures, about this compression bra can be found under Post-Surgical Camisoles on our website.

I’ve had reconstruction but I don’t want to do further nipple surgery, what can I do?
Reconstruction of the nipple usually takes place several months after breast reconstruction to allow proper positioning. After the healing time of breast reconstruction has passed, some women choose not to undergo further surgery. In this case, there are natural-looking silicone nipples that can be used directly on the skin or on a partial or full breast prosthesis to provide a natural look.

Why might I need a breast prosthesis during the reconstruction process?
Reconstruction surgeries are performed in stages, meaning there will always be a period of time that a woman has to wait between each surgery; this can be anywhere from three months to a year depending on the patient. This is a challenging time as breasts will be uneven, particularly in the case of reconstruction on one side and a natural breast on the other. During this time, a partial prosthesis can be worn to create visual balance and symmetry. There are partial breast prostheses specifically made to “grow with you” as your reconstructed breast size increases. These options include layered silicone prostheses, as well as silicone fronted prostheses with a fibre-filled backing. These styles can also be used for breast growth during pregnancy after reconstruction.

Why might I need a breast prosthesis after reconstruction?
Some women find a significant difference in size between breasts following reconstruction and will wear a partial breast prosthesis to restore natural balance and symmetry. A difference in size may occur due to weight gain/loss after reconstruction, weight/breast size changes during pregnancy, aging changes in the body, or may be the case directly following the original reconstructive surgery.

What questions are important to ask my doctor before surgery?
Can I have referrals from women who’ve had the same surgery?
Can I see photos of both successful and unsuccessful reconstruction surgeries?
Will my reconstructed breast match my other breast?
What types of reconstruction could I have?
What is the reasoning behind the type of reconstruction you have suggested for me?
What are the short and long-term effects of different types of reconstruction?
What happens when I gain or lose weight?
How will aging affect the reconstructed breast?
Will I need a blood transfusion? If so, can I donate my own blood?
What are my options if I am dissatisfied with the outcome?
What complications may occur and how are they handled?
Will I have feeling in my reconstructed breast?
What do I do if my arm swells (called lymphedema)?
What is the follow up plan for me after surgery?
How many surgeries might I need?
What is my risk of infection?
Will I still be able to have a mammogram if I get implants?
If my breast cancer came back, how would I know? What should I look for?
Will there be pain, scars, or changes in the parts of my body tissue is taken from (if using tissue flap)?

Assistive Devices Program

What is this?
The Assistive Devices Program, also known as “ADP”, is a government program that will reimburse you for a portion of the cost of your breast prosthesis. You are eligible simply by living in Ontario and having a valid Ontario Health Card. This program is not through OHIP, it is a separate program run through the Ontario Ministry of Health.

Who can apply?
Any permanent resident of Ontario who has a valid Health Card Number and:

  • Has had a mastectomy or lumpectomy
  • As a result of breast surgery now requires a breast prosthetic
  • Was born with a need to require a breast prosthetic

How do I apply?
Dianne will fill out all of the paperwork for you at your appointment. Please bring your health card because she will need to fill in your health card number on the form. We will provide you with a self-addressed, stamped envelope to send your form in by mail. You will receive your reimbursement by cheque in the mail.

How much money will I receive?
If you require one full breast prosthesis, you will receive $195. If you require two full breast prostheses, you will receive $390.

If you require one partial breast prosthesis, you will receive $105. If you require two partial breast prostheses, you will receive $210.

At the time of purchase, you will be required to pay the full amount of the breast prosthesis. ADP will reimburse you a portion of the cost, as listed above according to your needs. The remaining cost may be covered by your private insurance. If you do not have private insurance, you may use this as an income tax deduction. If you are on Ontario Disability Support Program (ODSP) or Ontario Works (OW), please contact us for further information on how you can apply and what your reimbursement will be.

How often can I apply?
You can apply every 2 years (24 months from date of purchase).

If, during the 2 years, you require a new breast prosthesis because your body size or shape changes or because of a change in your medical condition, you may apply once for a replacement during the 24 month period.

About Lymphedema

Why do I need to know about it?
Women who have been treated for breast cancer may be at risk for arm, breast, and chest swelling called lymphedema. Approximately 65-75% of women who undergo breast cancer treatment will develop lymphedema at some point. It may appear soon after surgery, months or years later, or never occur at all. Although it is not curable, it is highly manageable. Lymphedema can occur in both males and females, and falls into two categories: Primary and Secondary.

Primary Lymphedema: Usually caused by congenital abnormalities relating to lymph system. Injuries or severe hormonal fluctuations (ie. puberty or pregnancy) are often triggers.

Secondary Lymphedema:  Operations in which the lymph nodes are removed or disturbed are the usual causes. These operations include surgery for  breast, ovarian, testicular, or prostate cancer. Irradiation, injuries, inflammation, or infections can also lead to secondary lymphedema. The edema always occurs at a body part in which the drainage is impaired.

What is the lymph system?
Our bodies have a network of lymph nodes and lymph vessels that collect and carry watery, clear lymph fluid, much like veins collect blood from all parts of the body and carry it through the body. Lymph fluid contains proteins, salts, and water, as well as white blood cells, which help fight infections. In the lymph vessels, valves work with body muscles to help move the fluid through the body. Lymph nodes are small collections of tissue that work as filters for harmful substances and help us fight infection.

What is lymphedema & why does it happen?
During surgery for breast cancer, the doctor removes at least one lymph node from the underarm area to see if the cancer has spread. Sometimes doctors remove more than one. When lymph nodes are removed, lymph vessels that carry fluid from the arm to the rest of the body are also removed because they route through and are wrapped around the nodes.

Removing lymph nodes and vessels changes the flow of lymph fluid in that side of the upper body. This makes it harder for fluid in the chest, breast, and arm to flow out of this area. If the remaining lymph vessels cannot drain enough fluid from these areas, the excess fluid builds up and causes swelling called lymphedema. Radiation treatment to the lymph nodes in the underarm can affect the flow of lymph fluid in the arm, chest, and breast area in the same way, further increasing the risk of lymphedema.

Lymphedema is a build-up of lymph fluid in the fatty tissues just under your skin. It usually develops slowly over time. The swelling can range from mild to severe. Women who have many lymph nodes removed and women who have had radiation therapy for breast cancer have a higher risk of getting lymphedema.

If lymphedema occurs, what are my treatment options?
Lymphedema first appears as swelling. This swelling does not dissipate and can be indented with a fingertip. If left untreated, the swelling may increase and the skin will slowly turn fibrotic and feel hard to the touch. The swelling can increase further and eventually cause the skin to split and weep. It is far better to seek treatment early on, but lymphedema conditions can be improved at any stage. When treatment is sought early, the swelling can be reduced and managed to normal proportions.

Manual Lymph Drainage
This is a special type of skin manipulation conducted by a trained lymphedema therapist. Unlike massage, which implies deep or vigorous rubbing of the skin and underlying tissues, MLD is done with a light touch in order to manipulate the direction of the lymph flow. MLD is conducted on a regular schedule, usually once a day for two to four weeks.

*For contact information on MLD therapists in the GTA area, please contact us at 905-454-5710. We can provide you with a variety of names that come highly recommended by our customers.

Compression Garments
With MLD there will come a point where the dramatic change and decrease in swelling of the area will begin to diminish or plateau. This is the point where there will be little if any further change to the volume or size of the area. This is also the time when most patients are fitted for compression garments. Most compression garments are ready-made, but some will have to be custom made if the swelling is still severe. The patient will wear this garment all day, every day. Compression garments should be replaced every six months to maintain optimum compression strength.

Dianne’s Mastectomy has a wide variety of compression garments to fit your needs. We carry both arm sleeves, as well as compression stockings for your legs (needed for those with Deep Vein Thrombosis, blood clots, tired legs, etc). We carry day sleeves, which are worn all day, as well as night sleeves, worn during night. Not everyone who wears a day sleeve will require a night sleeve.

Lymph Drainage At-Home Therapy
Either in conjunction with or instead of MLD, there is an option that provides patients do perform their own lymph drainage at home using a lymph therapy machine. For more information on these pumps, please visit the Lymph Therapy Machine page under the Compression section of our website.

About Breast Prostheses

What is a breast prosthesis?
A breast prosthesis is the external breast form that will replace your natural breast after a mastectomy or lumpectomy. It is made of silicone so it will feel very natural to the touch. It is on the outside of your body and is worn inside the pocket of your mastectomy/surgical bra.

Why should I wear a prosthesis?
Not only will this balance you aesthetically, but anatomically as well. Without the weight of your natural breast, you may start to notice headaches or back & neck pain as your body may begin to atrophy forwards, compensating for the missing weight. Wearing a prosthesis will put proper weight back on your body to avoid these symptoms. As well, it will give proper weight within your bra so it does not shift or ride up your chest.

How long will I have to wait to be fitted with my prosthesis after surgery?
Most doctors will recommend you wait 4-6 weeks after surgery until you get fitted with a prosthesis. This allows time for your surgery site to heal and for you to feel comfortable wearing a bra again. We have everything here and in stock so when you leave your appointment, you will leave with your prosthesis.

Are there different kinds?
Yes, there are a variety of shapes, sizes and features to fit your needs. Everyone’s body type and surgery is different so there are different breast prostheses to fit your personal and specific needs. Dianne will go through this with you during your fitting.

Why might I require a breast prosthesis following a lumpectomy?
A lumpectomy preserves as much as the surrounding breast tissue as possible; however, the removal of the cancerous lump may cause a noticeable difference in size from the normal breast. A partial breast prosthesis will restore your natural balance and symmetry.

Why might I need a breast prosthesis after reconstruction?
Some women find a significant difference in size between breasts following reconstruction and will wear a partial breast prosthesis to restore natural balance and symmetry.

Reconstruction of the nipple usually takes place several months after breast reconstruction to allow proper positioning. After this time, some women choose not to have nipple reconstruction. In this case, there are natural-looking silicone nipples that can be used directly on the skin following reconstructive surgery. These nipples can also be used directly on a partial or full breast prosthesis to provide a natural look.

Can I wear a silicone breast prosthesis swimming?
Yes. Silicone breast forms will not be damaged by chlorine or salt water and can be worn in the swimming pool, ocean, or hot tub. After use, gently wash and dry the breast prosthesis. The breast prosthesis must be worn in a pocketed swimsuit so it does not float out into the water. You can either pocket your own swimsuit using sew-in pockets, or buy a pre-pocketed swimsuit. Please take a look at our swimwear options to discover what is best for you.

If you are a regular swimmer, you may wish to consider a swimform. This is an alternative to a regular breast prosthesis that is specifically made to allow water to flow easily during swimming. Silicone swimforms are hollow in the back to allow for water to move freely through your swimsuit without the weight of a full breast prosthesis. Non-silicone swimforms are made of spacer fabric that does not take on water. This material is a mesh which allows water to flow directly through it. It is extremely light as to not pull your swimsuit down as emerge from the water. It also features a tag which you can use to pin into your suit, rather than having a pre-pocketed suit.

What Are Mastectomy Bras?

How are mastectomy bras different from regular bras?
All of the bras we carry are referred to as mastectomy bras, or some people say surgical bras, meaning that there is an extra layer of material that creates a pocket behind the cup. This pocket allows the breast prosthesis to be worn securely, without falling out or shifting as you move throughout your day.

How does the breast prosthesis fit into the bra?
As mentioned above, all of our bras have a pocket behind the cup. The breast prosthesis will fit into this pocket much like a pillow fits into a pillowcase. Your breast prosthesis is transferrable between bras.

What’s the selection like?
There are many different bras to fit your personal preference or needs. They are not surgical looking, they look just like any other bra and come in all sorts of colours and designs. We have a large selection of bras including strapless, clear strapped, multi-way strapped, front opening, sport, etc. The designs vary anywhere from plain white, lace, or even animal print if you choose. You can view all of our bras here on our website, listed by manufacturer under Bras.

Will my size bra be available?
Not only do we have a wide selection in colour, design, and fit, but we also carry a vast selection of sizes. We have everything in stock, so you can leave with your bra the same day as your appointment.

I have private insurance; will they cover the cost of my bras?
Most insurance companies will cover the cost of mastectomy bras. All companies are different and provide different coverage. To find out what your coverage is, you will need to call your insurance company. For guidelines on what to ask, please refer to Your First Appointment page under the FAQ section of our website.

If you don’t have private insurance, you can use your bra receipts for an income tax deduction.

Before Surgery

It is highly recommended that you have a post-surgical camisole prior to your surgery because you can wear this garment directly home from the hospital.

The camisole has pouches to hold your drain tubes so they do not pull out as you move throughout your day, or as you sleep.  The pouches are removable so once your drain tubes come out, you can continue to wear it. Most doctors recommend waiting 4-6 weeks to be fitted for a breast prosthesis to allow time for swelling to go down, so this is what you can wear in the meantime. It is so comfortable that many choose to wear it as a lounge “around the house” shirt or night shirt even after being fitted for a breast prosthesis.

All of the stitching is on the outside, so there is nothing to rub against your surgery site and cause irritation. It is also made of a comfortable stretchy fabric, so if arm mobility is an issue following surgery you can step into it.

No-weight, fiber-filled shapers are included. They will give shape to your chest before you are able to wear a breast prosthesis. Many find this wonderful because they will have shape to their chest during the period of having family and friends visit, as well as attending medical appointments.

You can view our selection of post-surgical camisoles under the Accessories section of our website.

What To Expect

Before Surgery
It is helpful to know what’s available to you and what to expect following surgery.

Most surgeons recommend that patients should wait 4-6 weeks post-surgery to be fitted for a breast prosthesis. This allows time for the swelling to go down, for your surgery site to heal, and for you to feel comfortable wearing a bra again.

Prior to your surgery, you can purchase a post-surgical camisole to wear. It will not only be comfortable, but will be useful in securing your drain tubes immediately following surgery. You can wear this garment directly home from the hospital, as well as throughout your 4-6 weeks of healing.

Immediately Following Surgery
A post-surgical camisole can be worn directly home from the hospital and until you are healed and ready to be fitted for a breast prosthesis and mastectomy bra (4-6 weeks post-surgery). You can wear this throughout the day, but also at night as the inner pockets will keep your drain tubes secure during your daily activities or while you sleep.

4-6 Weeks Post-Surgery & Beyond
After your swelling has gone down and you feel comfortable to wear a bra again, you are ready for your first fitting! All fittings are private to allow you a fully comfortable experience. To know what to expect at your first fitting, please read Your First Appointment under the FAQ section on our website.

Your First Appointment

Why do I need to book an appointment?
Dianne works by appointment to ensure her customers receive privacy and personal attention. You will not have anyone walking in on you or interrupting your fitting. This is your time to be fitted for your post-surgical items and ask any questions you may have. There is no charge for your appointment.

What to expect:
When you come for your first appointment Dianne will fit you for a breast prosthesis and bra(s). You will be required to take your shirt off for this so you should wear a two-piece outfit on the day of your appointment. We carry our stock in-store so you will be able to leave with all of your purchases same day. You can even leave wearing it!

What to bring:
1) Health Card

  • We will need this to complete the government grant paperwork. For more information on this government program visit the Assistive Devices Program page under the FAQ section of our website

2) Private insurance information (if you have private insurance)

  • Many insurance companies will reimburse their clients for breast prostheses and mastectomy/surgical bras
  • Before your appointment, call your insurance company and ask:
    “How many mastectomy/surgical bras are covered?”
    “How often are mastectomy/surgical bras covered?”
    “How much of the cost will be covered?” (ie. 100%, 80%)

You will want to know this because every insurance company and plan is different. For example, some plans have spending accounts whereas others allow for 6 bras every calendar year, some allow for 2 every six months, and so on. Knowing this information may help guide your purchase choices.

If you don’t have private insurance, you can use your receipts as an income tax deduction.

3) Bringing a friend or family member is your choice. We have a waiting room for your guest to sit, or if you choose, they are certainly welcome to join you in your appointment.