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The breast cancer diagnosis was overwhelming enough. But then came the dozens of questions buzzing around in Patty White’s head, clamoring for answers. Among them: What will I wear after my surgery? It was 11 years ago that White, a resident of Norfolk, Virginia, went in for a double mastectomy as part of her cancer treatment. When she didn’t see any other options on the market for post-surgery clothing, she decided to settle for cheap men’s button-down shirts from Target. Her one wish then: more flattering clothes tailored for her post-operative needs.
Megan Sullivan has seen this struggle up close. In the winter of 2001, when Sullivan was just 9 years old, her then-42-year-old mom was diagnosed with stage 3 breast cancer, a life-altering event that galvanized Sullivan to leverage her degree in fashion design and launch With Grace B. Bold, a line of stylish clothes for women going through ordeals like the one her mother experienced many years ago. And while options have increased since White’s surgery, more than a decade ago, most of the choices today are very “loungewear focused,” says Sullivan, a Cincinnati-based businesswoman. “Many of these post-surgery clothes give women the feeling of bringing the hospital home with them.”
Also, argues Christine Guarino, founder of World of Pink, there’s no organized aftercare in terms of clothing following breast surgery. “The cancer and the breast have been removed, but then women are left to their own devices,” says Guarino, whose Long Island-based post-breast cancer organization works to restore balance and symmetry to women after surgery with a wide range of breast forms and prostheses.
Women (and men, and gender-nonconforming people) not only have to maneuver around these challenges, they also have to work with problems that present dressing challenges. Chief among them: leaky tubes that need to be hidden and a limited range of arm motion that severely restricts how easily they can dress themselves. These constraints accompany most breast surgeries, whether related to breast cancer or for other medical or cosmetic reasons.
Dr. Keith Blechman, a board-certified plastic surgeon with the Breast Reconstruction Center of NYC, says drains are used in breast cancer and reconstruction surgery to prevent fluid from accumulating underneath the skin. They have a bulb at the end and are sewn into the skin so they don’t fall out until the surgeon removes them, typically within a week or two after surgery. White remembers these drains as being one of the biggest headaches.
Dana Donofree, founder of AnaOno, a line of post-breast surgery intimates and clothing, says when women undergo a mastectomy, they wonder, “‘What am I going to do with these tentacles that are hanging out of my body?’ A lot of times, the surgeon will pin them to your surgical bra and send you out into the world,” says Donofree, who launched AnaOno after being diagnosed with breast cancer when she was just 28 and realizing the lack of fashionable lingerie and clothing for women to wear after such surgery. To handle the problem of drains, Joni Rubin, a California-based breast cancer survivor, remembers using a vest with pockets to hold them.
Grace Jun, a designer and social entrepreneur who merges fashion with technology to clothe underserved populations, points out that women shouldn’t have to cobble together such hodgepodge solutions, sacrificing style and self-image in the process. The problem with most of the apparel that can be worn after surgeries is that it sacrifices style for functionality, says Jun, who is the executive director of Open Style Lab, an MIT-founded initiative that currently operates at the Parsons School of Design in New York City, and assistant professor at Parsons’s School of Fashion. It is this kind of clothing that invites Donofree’s tongue-in-cheek label: the grandma bra. “[Apparel makers often] don’t realize that style can correlate with functionality,” Jun says.
Fortunately, there are more graceful and stylish solutions on the market. With Grace B. Bold, for example, offers the Ann Elizabeth, a fancy blouse that conceals the mastectomy drainage system. AnaOno’s recovery-wear line and World of Pink also offer elegant alternatives. As part of her thesis at the design and technology MFA program at Parsons School of Design, Jun designed clothes for breast cancer surgery patients with inside lining pockets to hold the tubes and bulbs. The pockets were detachable and could be thrown in the wash. Materials like wool that are more absorbent can handle night leaks better, she points out.
The garments on the market today also factor in the limited range of arm motion that accompanies breast surgery: The stylish clothes are easy to slip in and out of. “You basically have these T-Rex arms for a while,” Donofree laughs, remembering that her mother had to make a quick dash to buy a turquoise duster that Donofree could slip her arms in and out of easily. A friend bought her a zip-up hooded sweatshirt, and she lived in the sweatshirt and the duster for four weeks.
Mastectomy, a complete removal of the breasts, is not the only type of breast cancer surgery. As Dr. Blechman points out, a lumpectomy, where only a small portion of the breast is removed, is another common option. Donofree has seen that when younger women are diagnosed with breast cancer, they opt for a variety of treatment and reconstruction options. While the numbers show that women are increasingly choosing mastectomies, due to limited easy access to the procedure, a lack of education, and insurance hassles, not all go in for breast reconstruction. In fact, data from the American Society of Plastic Surgeons found that in 2016, “less than half of all women who require mastectomy are currently offered breast reconstruction surgery, and fewer than 20 percent elect to undergo immediate reconstruction.”
In essence, the number of different breast cancer surgeries and post-surgery reconstruction options leads to a dizzying variety of permutations and combinations. This literally means that one size does not fit all when it comes to post-surgery lingerie and clothing. How, then, do you dress these women and make them feel attractive again? “One breast, two breasts, no breasts, we cover it all,” Donofree says. AnaOno doesn’t use a cup system for bras, and its lingerie has no underwire. “We’re allowing your body to be your body and we’re dressing that,” Donofree says, adding that AnaOno offers stylish and sexy solutions for women from diagnosis to surgery, and through radiation and beyond.
Lacy bras and lingerie that make breast cancer survivors feel sexy again might be a good thing, but do they reinforce societal stereotypes about women’s bodies and what “sexy” means? Rubin, for example, admits that her struggles with self-image are real. “We live in a society that is all about looks and breasts, and it is something that I still struggle with,” she says.
Donofree sympathizes with this sentiment and agrees wholeheartedly. The solution, she believes, is for women to craft their own definition of sexy and to dress like their true selves. These clothes help them do just that. “If you’re down in the dumps and you’re like, ‘I’m not dressing like myself, I’m not expressing myself the way I want to’ because you’re never comfortable in your own skin, that’s difficult,” Donofree points out. “I identify my sexiness with the way I feel about myself and the ways I feel about the strengths I have with being a woman. That’s what makes me feel sexy.”
Since these intimates and apparel options include immediate post-surgery wear, patients wonder whether health insurance can sometimes cover payment. The general answer is no, Blechman says. “The Women’s Health and Cancer Rights Act of 1998 requires insurance companies to cover prostheses and reconstructive procedures [for U.S. patients]. Clothing is not necessarily covered under this legislation,” he says. Guarino says that in the United States, standard Medicare reimbursement is $300 per breast prosthesis form and approximately $15 to $30 per bra. The best advice Dr. Blechman gives: Contact your health insurance organization to see what they cover.
Important for many women is the fact that through the clothes they choose to wear, they retain control over at least one aspect of their lives during a wild and unpredictable time. “Cancer took so much away from me; it wasn’t going to take away my identity and self-expression,” Donofree says. “You’re going to lose your hair in chemo, you may lose your eyebrows and lashes. These are not necessarily things you have control over, but you can control how you look and how you feel.” And clothes are an important part of the path back to normalcy. “We like to get you into your life beyond breast cancer and hopefully back into the bedroom,” she says.
One of the prerequisites of clothing for women who have undergone surgery for breast cancer is that it carry them through an emotional rollercoaster ride. “I believe we present ourselves to the world with what we choose to wear, and I think our well-being is fulfilled in some way by confidence and the freedom to dress however we so choose,” Sullivan says. “There’s so much truth and power behind the statement, ‘When you look good, you feel good.’ I think it’s especially true for women faced with a diagnosis of breast cancer.”