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Tips for Sleeping with Tissue Expanders and Managing Discomfort

sleeping

Tissue expanders are an important step in breast reconstruction. While you can return to work and resume other everyday activities with tissue expanders, you may find that they cause discomfort, including disruptions to sleep. Here are our tips for sleeping with tissue expanders and managing discomfort in the tissue expansion phase after a mastectomy.

What are tissue expanders?

Tissue expanders are temporary implants placed above or underneath your chest muscle before placing silicone implants or undergoing flap reconstruction. These implants gently stretch the area over a multi-week or multi-month period to make room for an implant. If you are not undergoing an immediate reconstruction at the same time as your mastectomy, you may need tissue expanders to prepare your breast or breasts for implants later.

Tissue expanders come in different textures and shapes, depending on your desired outcome and your doctor’s recommendation. The tissue expander is composed of an empty implant and a small valve. Using the valve, a medical professional will fill your implant or implants with saline on a semi-regular basis, until your skin is stretched enough to accommodate the permanent silicone implant. How long you need tissue expanders depends on the size of the implant, your body, and your doctor’s recommendation. 

What do tissue expanders feel like?

Tissue expansion may feel like muscle cramping or tight muscles. These sensations are normal, especially in the hours after a saline injection. You may also experience breast tenderness or soreness if you have scar tissue. Your breast or breasts may also feel unnaturally stiff, as tissue expanders are not as flexible as implants.

If you are unsure if your discomfort is normal, your concern should be brought to the attention of a medical professional. Call your doctor if you are still experiencing pain more than 24 hours after a saline injection.

Tissue expanders vs. implants

Tissue expanders and implants are not interchangeable. Your tissue expanders will come before implants as a necessary step to prepare your body for implant placement. Before an implant is placed or flap reconstruction occurs, the tissue expanders are removed from your chest.

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Do you need to wear a bra with tissue expanders?

Choosing the right bra to wear with tissue expanders can be difficult, as your breast size is changing and the breast area is tender after surgery. While wearing a bra with tissue expanders is a personal choice, you may be more comfortable wearing one or find that a supportive bra helps relieve discomfort. If you opt to wear a bra while your tissue expanders are in, look for these qualities:

  • Choose comfort. Breathable fabrics and adjustable straps can be easily changed as your needs evolve.
  • Avoid underwire. Wire-free bras are much more forgiving for changing breast sizes. Underwires can also sit uncomfortably against sensitive skin and a tender chest as you heal.
  • Skip cup sizes. Molded cups will feel restrictive as your breast size changes. Forgiving, stretchy fabric accommodates changing breasts.
  • Consider a bra you can wear after tissue expanders. Bras like this lacey post-mastectomy bra are versatile, beautiful, and can be worn long after your reconstruction.

Tips for coping with tissue expander discomfort

Discomfort, soreness, and achiness are all normal while tissue expanders are making room for your implant or flap reconstruction. Understandably, these sensations can be distracting and unpleasant. Try these tips to help mitigate that discomfort:

  • Ice your breast. A cold compress can help reduce swelling. Ask your medical team before applying ice, as the cold may not be good for sensitive skin due to radiation.
  • Meditate. Pain management meditation guides can help you divert attention away from the pain you are experiencing. 
  • Use pillows. Breast pillows support sensitive areas as you cough, change positions, or undergo any other sudden movement. 
  • Try gentle stretches. Slowly and gently stretching your arms can help prevent stiffness and alleviate soreness in the chest area. Ask your medical team for some safe stretches and instructions on how to do them.
  • Distract yourself. Watching your favorite show or listening to good music can help take your mind off tissue expander discomfort. 
  • Speak with your surgeon about removing some saline. Your surgeon may remove some saline if the sensations are too much. However, less saline means the expansion process may be prolonged.
  • Use over-the-counter pain relief when needed. Acetaminophen or NSAIDs may be useful if other techniques do not help.

Tips for sleeping with tissue expanders

Tissue expander discomfort can keep you awake at night and affect your sleeping routine. This is especially impactful if you are a stomach sleeper and find sleeping on your back – the recommended position for the first few weeks of tissue expansion — to be unpleasant. If you are struggling sleeping with tissue expanders, try these tips:

  • Try meditation for sleep. Just like there are meditation guides for pain management, you can try a meditation guide to help you sleep. This guide can help you alleviate worry and promote calm so you can more easily fall asleep and stay asleep.
  • Use a body pillow to support your position. Body pillows can prop you up and hold you in a position that puts less pressure on your chest while sleeping. Look for a body pillow filled with kapok, a vegan fiber that feels just like down feathers. You can also place regular pillows underneath your head and knees.
  • Explore devices that can help you unwind. A sleep meditation light projects a halo of light onto the ceiling without disrupting your partner. Synchronize your breath to the light to help lull you into a more restful state.

Tips from our founder

“Prior to getting expanders put it, I had extensive pain from radiation damage. Bikram yoga was one of the reliable ways I was able to relax my chest wall for pain relief. Maintaining compression with tight-fitting sports bras also helped tremendously. As soon as I was able, I slept on my side with a moon pillow under the breast mounds with additional pillows as arm supports—I still sleep like this! After the drains came out and my incisions were healed enough, I found epsom salt baths in combination with yoga, compression, and pillow supports really helped me managed my discomfort and made sleeping with tissue expanders easier.” – Lisa Lefebvre, Mend Together Founder/2x cancer “endure-er”

As you prepare for breast surgery, tissue expansion, and reconstruction, Mend Together is here to help. Learn more about our free resources for people going through cancer and their loved ones. Our Community JournalVolunteer Calendar, and Gift & Donation Registry make it easy to give and receive support when it’s needed most.


Stella Morrison is an award-winning journalist who partners with mission-driven companies to share their stories. She is based in New York City.

Information provided here is not a substitute for medical advice. Please consult your healthcare team for advice tailored to your personal diagnosis and treatment.

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Guide to Wearing Breast Forms After a Mastectomy

mastectomy bra

If you chose not to go through reconstruction after your mastectomy, you may want to consider wearing breast forms to create the appearance of breasts. There are many to choose from and the variety can be overwhelming. This Mend Together guide will explain your options, how to get fitted for a breast form, and tips for wearing breast forms.

Types of breast forms

Breast forms vary in material, style, and purpose. Some of the options you will find include:

  • Silicone. Among the most popular designs, breast forms made from medical-grade silicone mimic the breast’s natural shape and weight. Some are filled with silicone, and some are filled with fiberfill.
  • Foam. More lightweight than silicone, foam breast forms are a good option for casual wear like lounging at home or while exercising.
  • Molded forms. Options like F(oo)Bs by Ana Ono provide shape without adding weight. “F(oo)Bs are a lightweight and affordable alternative to traditional prosthesis… add them to any pocketed bra when you want a little something extra,” says Ana Ono Founder & CEO Dana Donofree.
  • Breast forms for swimming. While other breast forms can get wet, it is not recommended to swim with them. Breast forms for swimming can be submerged without getting waterlogged and are lighter than silicone breast forms.
  • Partial breast forms. These are designed for use after a partial mastectomy, lumpectomy, or other breast surgery that removed some, but not all, breast tissue.
  • Knitted. Made by volunteers, these handmade breast prostheses are for women who have undergone a mastectomy, but not reconstruction. They are soft, comfortable, and beautiful and when placed in a regular bra they take the shape and feel of a real breast. 

How to wear breast forms

There are two main ways to wear breast forms: inserted into your bra or as attachable forms that stick to your chest. 

When wearing breast forms in your bra, you can do so with a mastectomy bra. These garments have special compartments for holding breast forms in place. Most models are designed with comfort in mind, such as front closures and adjustable straps, and many are wire-free to better accommodate breast forms. There are several styles available, including lacey and feminine mastectomy bras, bras designed to help reduce pain, and everyday bras built for comfort and easy wear

Attachable breast forms use an adhesive to hold the form directly against your chest. Typically made of silicone, attachable breast forms can be worn with any bra and in most situations without worrying about them slipping. You may also find them to be more comfortable, as silicone can be heavy and adhering them to your chest can help distribute their weight more evenly.

How to get fitted for breast forms

  • Step 1: Determine your band size. Measure under your bust with a flexible tape measure to determine your band size.
  • Step 2: Determine your cup size. If you underwent a single mastectomy, you may want to choose a matching cup size. You have more flexibility regarding your desired size if you underwent a double mastectomy but consider how the cup size will look in proportion to the rest of your body.
  • Step 3: Select your breast form or forms. As discussed above, you have many options when it comes to material, shape, and purpose. It is totally fine to choose more than one to wear on different occasions.

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Tips for feeling confident

  • Play around with placement. This is your body, and what is most comfortable for you is what matters most. Experiment with different positions in your bra or on your chest to see which placement supports the look you want.
  • Take your lifestyle into account. While you can certainly buy multiple breast forms for different occasions, you want to select the options that work best for your everyday life. If you are very active, for example, foam inserts may be a more lightweight alternative to silicone.
  • Get fitted by a professional. Someone with experience working with mastectomy bras and breast inserts can best help you select the right size, shape, and material for your body. Do not hesitate to ask questions about positioning and care, too. 
  • Remember to consider shape. Breast forms are available in several shapes, including triangle, oval, round, and teardrop. Select the style that is closest to the look you want, or if you only had one breast removed, one that is closest to your other breast.

Aftercare

Washing your breast forms every day ensures that they will stay good as new for years to come. Silicone breast forms can be washed by hand with mild soap and water; dry thoroughly before use. Foam breast forms can also be washed by hand with mild soap and water; or in the washing machine on a delicate cycle and in a special bag. Check the cleaning instructions that came with your breast forms for specific care instructions.

Whether you are building a registry for yourself or shopping for a loved one, Mend Together offers many practical gifts for anyone who has undergone breast surgery, including reconstruction after a mastectomy. Our website offers dozens of options, including mastectomy bras that hold breast forms, which have been carefully evaluated for quality. Visit the Mend Together website to browse registries and gifts, or start a registry of your own.


Stella Morrison is an award-winning journalist who partners with mission-driven companies to share their stories. She is based in New York City.

Information provided here is not a substitute for medical advice. Please consult your healthcare team for advice tailored to your personal diagnosis and treatment.

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8 Inspiring Mastectomy Tattoos & Ideas

After breast cancer surgery, you may opt for a mastectomy tattoo to cover up or even showcase your scars. Mastectomy tattoos come in all sorts of styles and sizes, tailored for personal taste and meaning. This Mend Together guide includes information, tips, and inspiration if you are considering a mastectomy tattoo.

What is a mastectomy tattoo?

A mastectomy tattoo is a tattoo applied to your chest after breast cancer surgery. Women who have undergone lumpectomies, a single mastectomy, or a double mastectomy can all get mastectomy tattoos once their surgical sites have fully healed. They come in many designs and can hold deep meaning for the person who gets them. Mastectomy tattoos can be a powerful way to feel in control of your body after cancer treatment.

How long after a mastectomy can you get a tattoo?

Your surgical site or sites need to be fully healed before getting a mastectomy tattoo. How long you need to wait depends on your healing process, your treatment plan, and the advice of your medical team. Many oncologists and plastic surgeons seek to minimize the risk of infection after surgery by limiting additional procedures. Some patients need to wait a few months, while others should hold out for longer than one year. Speak with your doctor to determine the timeline that is best for you.

Does insurance cover mastectomy tattoos?

The answer depends on the type of tattoo you are getting. Mastectomy tattoos are considered a cosmetic procedure by most insurance companies, so it is safe to assume that your tattoo will be an out-of-pocket cost.

However, if you are getting a 3D nipple tattoo, this may be covered by your insurance plan. The Women’s Health and Cancer Rights Act of 1998 requires insurers to cover the cost of 3D nipple tattoos for those who underwent breast cancer surgery. This coverage can vary by state and your insurance plan, so speak with your insurance company for specific information.

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8 inspiring mastectomy tattoo designs

These inspiring mastectomy tattoo examples can help you decide which look is best for you.

1. Floral designs

Symbolic of life and rebirth, a beautiful bouquet can hold deep meaning while effectively covering mastectomy scars. This tattoo type looks good on all breast surgery types, including

2. Lingerie design

This cheeky wink to femininity and sexuality can hold power if you are carrying a sense of loss related to your mastectomy. Tattooing a bra can be a way to “reclaim” what is missing.

3. Phoenix & winged design

This deeply symbolic mastectomy tattoo hearkens rebirth and rising from the ashes, a powerful message for someone who has undergone breast cancer treatment or surgery.

4. 3D nipple tattoo

While technically different from mastectomy tattoos, 3D nipple tattoos are a good option if you want the lifelike appearance of a nipple. If you are considering a 3D nipple tattoo, you can try temporary tattoos to test different styles and shades before you make a commitment.

The work of Marnie Rustemeyer, owner of Billow Global, is celebrated for its lifelike results. The Mend Together shop also carries Billow Global breast surgery heart pillows and mastectomy body pillows

“In 2013 I was diagnosed with the BRCA gene mutation and elected to have a double mastectomy to reduce my risk of having breast cancer. Through my own experience, I became passionate about helping patients feel beautiful, confident and complete again after such an emotional and demanding journey and started my company, Medi Ink, LLC. Services that I offer through Medi Ink include 3D areola restorative tattooing, scalp micro-pigmentation scar camouflage and cosmetic tattooing. This work is incredibly important as it restores something that was lost as a result of having breast cancer, instilling hope and confidence in my clients.  I absolutely love seeing them shine again following their procedures!” -Marnie Rustemeyer, Founder/Owner Medi Ink, LLC

5. Decorative areola tattoo

If you want something in between a mastectomy tattoo and a 3D nipple tattoo, get creative with areola reconstruction. You can transform this area of your breast into a flower, heart, star, or another fun shape.

6. Design that incorporates scars

Not all mastectomy tattoos are for hiding scars. You may choose to embrace and celebrate your scars by getting a tattoo that incorporates the scar or scars as part of the design. When it comes to this design, your imagination is the limit: You can get a clever tattoo, an elegant tattoo, or even something humorous.

7. Butterfly design

Butterflies are symbolic of transformation. You may find this fitting metaphor to be a meaningful and moving symbol for life after a mastectomy and cancer treatment.

8. Lace design

Like the lingerie design, the feminine touch of lace may be especially meaningful if you feel like you lost a part of womanhood after your mastectomy. This beautiful example from Sue Cook illustrates what this elaborate design can reclaim. Cook told People.com that she wanted to “almost re-create the feeling I used to get when I wore beautiful lace underwear,” adding that cancer “does not always need to leave the last mark.”

Tips for finding a mastectomy tattoo artist

  • Look for someone with mastectomy tattoo experience. Consider working with an artist who has previously worked with clients who have been through the trauma of cancer. This experience informs their approach and can help you develop your desired result.
  • Collaborate with your tattoo artist. During the tattoo design process, you will work closely with your tattooer to sketch and refine your design. Do not be shy: Sharing your opinion and feedback is the only way to ensure your tattooer knows what you want.
  • Bring ideas. If you are struggling to articulate what you want, you can bring pictures of other tattoos that you like for inspiration to your appointment with the artist. You can use Pinterest to organize some ideas, or check out programs like P.ink that offer resources for those considering a mastectomy tattoo.
  • Reach out to others. Through Mend Together, you can share inspiration and collect ideas from others using our Journal feature. Create a post that collects your favorite examples, and you can ask others for their opinions and ask for recommendations for mastectomy tattoo artists.

Moving forward with Mend Together

As you explore your options after breast cancer surgery, you may find deep meaning in the beauty and power behind a mastectomy tattoo may call to you. Whether that takes form as a bold floral that covers up your scars, the lifelike appearance of a nipple, or something in between, your mastectomy tattoo can hold transformative power. The decision is up to you.

Mend Together’s free resources can help guide you and your loved ones during and after a breast cancer diagnosis. Whether you find comfort in sharing updates through the Community Journal, want to build a Gift & Donation Registry with helpful items after surgery, or you want to create a Volunteer Calendar to organize practical support, these tools help you and your loved ones navigate the challenges that lie ahead. Start your free account today.


Stella Morrison is an award-winning journalist who partners with mission-driven companies to share their stories. She is based in New York City.

Information provided here is not a substitute for medical advice. Please consult your healthcare team for advice tailored to your personal diagnosis and treatment.

Cover photo by Gigi Stoll, tattoo by Miranda Lorberer