Post-Mastectomy Self Care... From A High-Maintenance Brca2 Mutant

March 13, 2016  •  Leave a Comment

Many women struggle with body image after breast surgery. We have just made a life and death decision, and as a result, the landscape of our bodies has completely changed overnight. Adding insult to injury, we have just temporarily lost the upper body strength to groom and dress ourselves. Whether you are about to go for chemotherapy or you are going straight to reconstruction, self care is a daunting task when your arms have limited mobility and your chest is freshly sutured together in multiple spots.

For mastectomy survivors and previvors, the amount of time and money you have to spend in doctors offices is already ridiculous. This is not a good time to indulge in expensive department store makeup that you won't be using everyday, but that doesn't mean you should deprive yourself, either. Having body parts removed is a stressful event and you have every right to feel pampered right now. If you are a product junkie, I recommend gathering a handful of effective multitasking products that make you feel like you just stepped out of the spa, even when you can barely get out of bed. Envision your home as a healing retreat, and gather everything you would want by your bedside while you are recovering. Here are a few tips for post-surgical comfort, cleansing, and beauty.


For Sparkly Girls Who Chose Mastectomy When Surveillance Was Enuf...

- Before you go for breast surgery, make sure your house is ready. Stage your ideal recovery area in the days leading up your mastectomy. Stash some extra wound dressings, sterilizing alcohol wipes, an ultra hydrating lip balm, eye drops, and your favorite fragrance free moisturizer in your nightstand or as close to your bed as possible. If Feng Shui is your thing, realign your bedroom properly. If luxury bedding is your thing, treat yourself to some smooth new linens, satin pillowcases, or blackout curtains. Don't forget to place your favorite candles, books, and music within reaching distance. I wanted my room to feel just as relaxing as the treatment rooms in the spas I used to work at. You are about to be there for a few days, so do whatever it takes to feel fabulous in your bed. 

- Get a very long exfoliating body brush and an even longer foot file for easy head-to-toe cleansing. Bending and reaching will be impossible at times, so prepare yourself for limited arm mobility. I used 3M Command Waterproof Hooks inside the bathroom shower so that everything is as easily accessible while bathing. Some of you may even choose to invest in a shower chair. Make sure that all your bathing tools are placed on your waterproof shower hooks before you leave for surgery. You might be coming home with a couple of extra drainage tubes hanging out of you. When you are strong enough to shower again, you will need to clip your drain pouches together and hang them somewhere safely in order have your arms free to scrub. Keep that in mind when you are pre-setting your bathroom.

- Keep a refreshing, alcohol-free, cooling mist within arms reach at all times. Your surgeon may actually advise you to skip showering and keep the post-mastectomy surgical dressing dry for the first few days. To stay fresh when showering is impossible, use a botanical mist with cooling anti-inflammatory properties, preferably one that balances your skin's pH and delivers light moisture. Sometimes all it takes is a blast of hydration and antioxidants, and your glow returns immediately. I have been obsessed with using botanical sprays since I was a makeup artist for Shu Uemura, a skin care brand well known for their kelp-derived Depsea Hydrating Mists. For a less expensive version, there are organic rose water or cucumber water sprays in the beauty aisle at most health food stores, and fragrance-free mineral water mists by Vichy and Evian available at Ulta and Target. I guarantee this will become a lasting part of your home beauty routine.

- If you are staying overnight in the hospital, pack light and only bring your best multi-tasking skin care. I naturally gravitate to products geared to sensitive skin, with little to no added fragrance, alcohol, sulfates, or other potential allergens that could irritate post-surgical skin. A day or two after my mastectomy, I was mobile enough to use my Burt's Bees Sensitive Skin Cleansing Wipes along with my facial mist.

- Use a Clarisonic or your favorite motorized exfoliating brush for facial cleansing during the healing process. Repetitive back-and-forth arm motions are going to be difficult for a few weeks, and may get more uncomfortable depending on how you choose to reconstruct. I've been using my exfoliating brush with my favorite cleansing oil to avoid over exerting my arm/chest muscles during reconstruction.

- Find a moisturizing dry oil spray for hard to reach dry spots. After showering and drying off, you won't have the energy left in your arms to apply lotion. Trust me.

- Don't forget that healthy skin starts inside. Feed your healing body by munching on cucumbers, carrots, almonds, avocados, and your favorite raw foods that are rich in vitamin E and Omega 3 fatty acids. Your skin is your canvas, and proper nutrition will help to heal it and keep it smooth.

- If you must spend money on products, always invest in good eye cream and a great exfoliator. I've found wonderful body washes and shampoos that are free of dyes, sulfates, and artificial fragrances (all known irritants for sensitive post-surgical skin) at my local drugstores and health food shops. When you decide to invest in pampering yourself with spa quality professional skin care, look for something that is going to give you antioxidant protection and long-term results instead of buying a 30 dollar mascara that will probably go bad before you finish the tube.

- Stock up on no-rinse hair cleansers and conditioning sprays. Reasons and techniques for breast surgery vary from person to person, but there is one common complaint. There are going to be days after your mastectomy when, although you have the energy to shower, you absolutely physically can not lift your arms above your head to wash, braid, blow dry, or style your hair. Eventually your arms and chest will be strong enough that, after you take a muscle relaxer (or two), you can get the job done. Until then, invest in a dry shampoo or no-rinse cleansing spray that is best for your hair type. It will be essential for getting through the first few weeks.

- Invest in stylish headwear. Although there are many convenient shortcuts for freshening up your hair without hurting yourself, this is also a great time to step up your accessory game and invest in some grownup hats that work well with your wardrobe. This is a crucial step after breast surgery, whether you are having chemo or not, because reaching above your head varies from extremely uncomfortable to impossible at times, depending on where you are in the healing/recon process. If you are having breast surgery as a precursor to chemotherapy, you probably already know that human hair wigs can cost hundreds of dollars. Stylish scarves and wraps are more economical in the long run. Truly fabulous hats and chic turbans can be timeless statement pieces that you will want to wear forever, long after your hair grows back and your arms regain their range of motion. You might be ready to dress your self and go back to work, but still not have the arm power to style your hair. What would Jackie Bouvier Kennedy do? What would Erykah Badu do? What would 70s Liz Taylor do? 

Arrive at your Easter Brunch, drink all the champagne, and leave a trail of glitter.

-Minimize your makeup routine to the bare bones. It's totally normal if you want to freshen up before your crew arrives to help you with household chores (because they will do that, if they are decent human beings), but please do not wear yourself out. You just had major surgery, and divas have days off, too. For an effortless polished look, try Black Opal Invisible Oil Blocking Powder. It's a drugstore cult darling among makeup artists and retails for less than ten dollars. Use it alone to blot off excess shine, or over your favorite BB/CC cream. This is not the time to waste money on luxury makeup, and this powder works just as well as some department store brands that cost 3x more. Save your money during reconstruction, because you will need every penny for your hospital bills, prescription co-pays, medical supplies, and the unexpected related expenses that may pop up.

- Remember that surgical prep instructions ask that you don't wear nail polish on your fingers or toes in the operating room. Treating yourself to a last minute spa pedicure is a relaxing way to take your mind off what's happening to you, but otherwise pointless. If time and money allow for a pre-surgical pampering spa visit, consider booking yourself for a last minute facial, waxing, or lash extensions. For a beauty treatment that last through most of your medically-induced hibernation, lash extensions will give you the most bang for your beauty bucks. Isabelle Williams is a friend of mine from my days working at Red Door in Chevy Chase, and one of the best eyelash extension specialists in the Washington DC area. Isabelle lashed me up a few days before my mastectomy. She offered me the choice of a short, more subtle lash length, but clients who are used to wearing a couple of coats of mascara on "minimal makeup" days will prefer a longer, curvier lash. I told her that I wanted to wake up with an effortless smoky eye every day, and that's exactly what I got. When I was still in the hospital feeling like "Shaq is wearing cleats and standing on my chest" (the first thing I said after waking up), my lashes were on point, honey. A few hours after surgery, I looked in the mirror, opened that surgical gown and saw my new post-mastectomy body for the first time. Maybe it was the anesthesia talking, but I said, "Damn girl...your boobs look like Hot Pockets right now and you still look incredible." When was the last time you gave yourself a Two-Syllable Damn? Were you in the hospital when it happened? Probably not. The extensions didn't damage my natural lashes because they didn't break off, but gently fell out over time. Even without making follow up maintenance appointments, my lashes still lasted me six weeks!

In case you were wondering what part of your adult life marching band was preparing you for... this is it.

- You may think you already have enough pillows, but you probably don't. Hospital bed wedges and small underarm pillows are essential for your post-mastectomy lounging comfort. Someone asked me to describe the feeling of breast reconstruction via tissue expanders, but I haven't felt anything like this since I was in high school. The sensation is almost exactly like wearing a drum harness, but under the skin. My torso was top heavy and stiff, totally immobilized in some areas, and bringing my arms together in front of my body was challenging. If you were NOT a busty teenage percussion player and can't relate, try strapping a couple of two by fours to your chest at armpit/bust level for the similar weight and stiffness, and then try washing your hands or bending over to tie your shoes. Hugging is weird. Driving is possible, but awkward. I hear that some people can sleep laying down, but I was not able to for weeks. Reclining was most difficult for me at later stages of expansion. 

- Get used to seeing a different body every time you pass a mirror. Remember when I said my post-mastectomy boob nubs looked like Hot Pockets? That probably won't last forever. The tissue expanders totally change your silhouette with each fill. As you go through the expansion process, there is no static level of comfort. That means they are doing their job. For a lot of us, breast reconstruction is going to be a series of procedures, and not a single event. Every time you go to the doctor for expansion, wear a button down shirt that you can slide in and out of easily. Don't forget to bring your best seatbelt pillows because you will definitely be sore on the way home. Along with the stretching and growing comes occasional stiffness and pain. I named my tissue expanders Bishop and Ash, after the cyborgs from the "Aliens" movies. One side functioned so naturally, sometimes it was possible to forget there was artificial technology under the flesh. The other side was Ash. I often find myself injecting humor into situations through music, so I made a motivational breast reconstruction playlist and filled it with oddly relevant Grrl Power anthems from my youth. Some times to get through the pain, I sang along with Patti Labelle, "Know where I'm goin' and I know what to doooo... Oo-oooo, oo-oooo, oooooooooooh, I GOT A NEW PAIR OF BOOBS."

- I don't care how strong, how proud, how modest, how independent, or how much of an introvert you think you are, people are going to have to help you out for a little while. Shut up, sit back, and let them, because you physically can not do this alone. My friends stepped up and took turns with my family. I had another procedure two weeks ago, and they are still coming by to keep me entertained, cook meals, bring groceries, and help me out with household chores. 

- Netflix and Pills. Rest. Rest. Rest. And rest some more. Take what your doctor gave you. Nap like you are getting paid for it. Watch Attack The Block or Mad Max for the 99th time. Work on some crafts or sewing. Write in your journal. Sit still and heal. 


Winter is usually the slowest time of year for photo shoots and weddings, so I decided to schedule my breast reconstruction hibernation period accordingly. As a freelance makeup artist, I work with my hands, on my feet all day, and depending on the location I may have to drag a 5 to 10 pound makeup kit down escalators, across grass, and/or up dozens of marble steps. All of this requires arm strength that I just don't have on some days. I keep telling myself that it could be worse. I remind myself daily that my mother worked at a preschool post-mastectomy, and attended chemotherapy on afternoon breaks while other people's toddlers were napping. Along with the BRCA mutation and my killer rack, I also inherited my insane work ethic from her. 

My agency and my fellow artists have gone above and beyond, standing by to cover gigs for me if my chest muscles weren't cooperating, and making sure that the shoots I actually got out of bed for were totally worth it. There have been days that I actually love the challenge of running around set with the sensation of bricks in my chest. I started 2016 by making a list of fascinating and inspiring people that I really wanted the chance to work with, and thanks to my booking agent, a few days later I ended up shooting with one of them. 

The Honorable Ms Lynch.

My original intention for writing this breast surgery aftercare list was to share with other folks prepping for a mastectomy, but I can imagine that anyone who has had their chest opened up and pectoral muscles moved for any reason at all is going to experience similar challenges in their grooming routine. I had the luxury of planning a double mastectomy for a few years, because of my genetic status. If you know someone who just found out that they need a mastectomy last month, last week, or yesterday, please share this post and the following links with them.

If you think that you may be at high risk for hereditary cancer, Bright Pink has information that may help you in your quest to understand genetic testing and begin early screening. My family is affected by BRCA2 cancers, and my inner circle understands that I have been in a cycle of preventative medical surveillance, surgeries, and recovery for the last ten years. Unfortunately, not everyone has access the same kind of family support system, and people around you who think "it's just a boob job" may be the very same folks that you have to lean on temporarily. Medical acronyms like BSO, HBOC, DIEP FLAP, and PBM are familiar to cancer survivors and previvors, but the rest of the world doesn't know what they mean because they don't have to. Direct your family, friends, or roommates to a web page that describes in medical terms exactly what procedure you are having done, if that's what it takes to get them to understand that you need help. Some of them will be too squeamish to finish reading it, but they need to know that mastectomies are serious surgeries with certain specific aftercare needs. My surgery and recovery was a group effort between my friends and family, and a medical team including a dermatologist, a genetic counselor, a gynecological oncologist, an occupational therapist, and a couple of plastic surgeons. My prophylactic breast surgery was not a "boob job" because the alternative for me is death, not a flat chest. 


"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

-Audre Lorde, A Burst Of Light



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