Managing permanent changes to appearance
If you have permanent changes caused by cancer treatment, there are ways to help you manage these.
You will need time to recover from treatment and to adapt to body changes, especially if they are more permanent. There are ways to help you to manage your body changes and improve your confidence.
You need to talk to your cancer doctor or nurse about some of these things. You can do others with support from family or friends.
Taking care of yourself and your body is important. It may help you develop a more positive body image.
Before treatment, your cancer doctor and nurse will give you information to prepare you. They will tell you how the treatment is likely to affect you. They will explain any options, such as reconstructive surgery, and can help you make decisions.
They can also:
- tell you about possible side effects and what may help
- refer you to other members of the team, for example occupational therapists, physiotherapists or speech and language therapists
- refer you for services such as counselling, if you think that would be helpful
- arrange for a second opinion about your treatment, if you feel this would be useful.
Always let your cancer doctor or nurse know if you have body image concerns during or after treatment. There are different ways they can help and support you.
Reconstructive surgery is most commonly needed after some types of surgery to remove the cancer. For example, a woman may choose reconstructive surgery after having a breast removed (mastectomy). Another example is when a surgeon replaces tissue or nerves removed during treatment for head and neck cancer or skin cancer.
Reconstructive surgery may help you to feel more confident about your appearance.
Breast reconstruction can be done immediately or years after a mastectomy. If you had surgery to remove only part of the breast, you can have surgery to improve the shape. Your doctor or breast care nurse will talk to you about this. They can refer you to a specialist surgeon.
Scars usually improve in how they feel and look in the months after surgery. They gradually fade and become softer over time.
Sometimes people are unhappy because of how a scar looks or if it feels tight and uncomfortable. This may cause concerns about your body. It could also affect relationships and how you feel about being physically intimate with another person.
Tell your doctor or nurse how you feel about the scar. There are usually different treatments that may help. You may have a combination of these. You can use skin camouflage make-up to help make a scar less noticeable.
Your doctor may prescribe creams or gels to help a scar heal, make it feel softer or lighten its colour. If a scar is uncomfortable and stiff, physiotherapy may help to soften it and make it more comfortable. Steroid injections may be used to soften and flatten certain types of scar.
It may also be possible to have surgery to make a scar less noticeable. Doctors call this scar revision. A surgeon can do this under a general anaesthetic or sometimes under a local anaesthetic. You may have to wait up to a year or sometimes longer after your first operation to have this done.
If you wear any type of prosthesis (false body part) and do not feel confident, talk to your nurse or doctor. The prosthesis may not be the right fit, type or colour match for you. This could be because it was not correct to begin with or because it is now damaged. Or it could be that your body weight or shape has changed since it was fitted.
Even if your prosthesis is still in good condition, they can arrange for you to be reassessed. If you have had the prosthesis for a while, there may be new, improved types available.
There are different ways to cover up changes and to help you feel better about yourself. Different people can help you with this. This includes your healthcare team, who can:
- advise you about clothing and accessories, for example using a scarf to cover up hair loss
- make sure you have the most suitable and least visible product, for example a speaking valve after surgery to remove the voicebox (larynx)
- refer you to Changing Faces or the British Association of Skin Camouflage for advice about camouflage make-up
- refer you for a replacement part (prosthesis), for example a breast prosthesis.
If you have had skin grafts (skin replaced with skin from another part of the body), the colour may not match your surrounding skin. Or you may have visible scars you would like to cover up. Using camouflage make-up can help.
Changing Faces has trained skin camouflage practitioners. They can find the best colour match for your skin tone. They can also teach you how to apply the specialist waterproof cover creams and powders. You can get these on prescription. Changing Faces runs clinics across the UK.
If you wear a prosthesis and it does not match your camouflage make-up, go back and see the person who supplied it. They can match the colour to your camouflage make-up.
Look Good Feel Better
Look Good Feel Better (LGFB) has trained volunteer beauty professionals who run free workshops for people coping with cancer treatment. Workshops are available in over 80 hospitals and specialist cancer centres across the UK. Ask your nurse or doctor for a referral in your area.
Depending on the body change you have, you can get advice on clothing from support organisations, for example Breast Cancer Care, Changing Faces, Colostomy UK, the Ileostomy & Internal Pouch Support Group or the National Association of Laryngectomee Clubs. Online forums are also a good place to get advice.
Here are some tips that might help:
- If you have had surgery to the tummy area, have swollen legs or have put on weight, trousers with drawstring or elasticated waists or flat-front trousers are good.
- Long skirts, with or without slits, or wrap skirts can be a good alternative to trousers.
- If you have had a mastectomy and used to wear lower-cut dresses before, try wearing a camisole top underneath.
- High V-neck shirts help if you want to cover a scar or central line in the chest area.
- High, mandarin-type collars or polo necks help cover up your neck area.
- Patterned shirts draw attention to the pattern and away from other areas.
- Bell-shaped sleeves are good if you have a swollen arm.
- Accessories help give different looks to one outfit. They also draw attention to certain areas and away from others.
- Avoid drawing attention to a change by hiding it. For example, instead of a high-necked jumper in summer, try a lightweight scarf.
If you need to buy new clothes because of body changes and cannot afford it, ask about a Macmillan Grant.
After surgery that has changed their appearance, some people may choose to get an artistic tattoo. For example, this could be after breast surgery such as a mastectomy or other types of surgery. It may be to cover a scar or to do something special that honours what their body has been through. It may make them feel more confident and as if they are reclaiming their bodies.
It is important to talk to your cancer doctor or nurse first. You need to know if there are concerns about the skin in the area. Your operation sites need to be completely healed. This may take up to a year but it can be longer. You should have also finished any chemotherapy or radiotherapy treatment.
Breast Cancer Care has more information about artistic tattoos after breast surgery.