After a mastectomy, even if you have breast reconstruction, your bra needs will likely be very different from what you wore before your surgery.

Wearing a bra after breast reconstruction is optional, whether you have new breasts made with implants, your own tissue, or both; your new “girls” will likely be higher and firmer than your natural breasts. But wearing a bra helps to minimize the inevitable effects of movement and gravity, and keeps your new breasts in proper position on your chest. About three months after your reconstruction, when your incisions have healed, and your surgeon gives you the okay to wear regular bras again, you can decide whether you want to or not. But your pre-mastectomy bras will probably no longer fit, because your new breasts may be a different shape or size than your natural breasts.

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Projection is the problem

Finding a bra that fits the size and shape of your reconstructed breasts probably won’t be difficult, but finding one that fits the front of your new breast can be more challenging. That’s because in most cases when immediate breast reconstruction (at the same time as mastectomy) is performed, a horizontal incision is made across the nipple and areola, which are removed along with the breast tissue.

Depending on the location or size of the tumor, additional skin may also need to be removed, which can further compromise projection. Eliminating the nipple in this way and then closing the incision flattens the natural projection of the breast. This usually results in a reconstructed breast without enough projection to fill the front of most bras. (If you choose not to have reconstruction, your breast tissue and most of your breast skin will be removed through a wide incision across your chest, leaving it flat. You may prefer to remain that way or wear prostheses that either adhere to your chest or fit within special “pocketed” bras.) 

Most important to your post-reconstruction projection is the location of your mastectomy incision. Projection tends to be better when a vertical mastectomy incision is used. It’s also more likely with “nipple-sparing” mastectomies that remove breast tissue but preserve the natural nipple and areola. Before your surgery, it’s a good idea to speak to your breast surgeon about how the placement of your mastectomy incisions can facilitate your reconstruction.

The type of reconstruction can also affect projection on your new breast. Implants tend to produce flatter, round breasts that may limit you to wearing padded bras or seamless stretch bras. Reconstruction with your own tissue creates a more natural-looking breast, but it can still be somewhat flat on the front of the breast if a horizontal mastectomy incision is used.

You can still wear and enjoy comfortable, pretty and sexy bras. It might just take a bit more time and effort to find the styles and sizes that best fit your new breasts.

Remember these tips when you’re ready to dress your new breasts:

• Consult with a professional fitter before choosing a bra, because all bras fit differently. If a fitter is unavailable, check the lingerie brand’s fitting guidelines. (Learn more about bra sizing and styles.)
• Be more concerned about a proper fit, rather than cup size, especially until you determine what types of bras your new breasts do and do not accommodate.
• Always try new bras on before buying.

Are you struggling to find bras after breast reconstruction? What's been your experience?

Kathy Steligo is the author of The Breast Reconstruction Guidebook.