Awkward Auntie Question No. 9

question-no-9

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Question: How carefully do reconstructed breasts need to be handled? My husband and I are going to be getting back into having sex in the new year and I would like to have a medical professional’s opinion on the potential risk of damaging the newly grafted fat. Is everything fair game once I’m allowed to sleep on my stomach again? Are breasts reconstructed from my own tissue safe to handle like original breasts? What about various types of implants (just in case others have the same naive question I do but had different reconstruction)?

I’m 38 and had stage 2 invasive ductal carcinoma in one breast; no chemotherapy (no spread to lymph nodes), no radiation (bilateral mastectomy); I’m on tamoxifen; I had a total hysterectomy and salpingectomy but still have both ovaries. I had a bilateral mastectomy and insertion of tissue expanders, removal of the expanders and DIEP flap reconstruction (I no longer have any kind of implant), and finally fat grafting and revision (removal of the grafted skin patches, and the dog ears on the abdominal incision). One month after the revision surgery, I was applying silicone lotion to the scars as instructed and the skin at the end of my abdominal scar opened up and my finger went into my side; it’s been stitched up again but this made me nervous about the strength of my pieced-together skin and tissue. I feel ridiculous asking my surgeon about how touchable my new boobs are though.

Awkward Auntie: You have really done it all – or had all done to you! And it must have been quite shocking to find your finger under your skin – but that was in the early stages of healing (one month later) and in general terms, we say that full healing takes at least 6 weeks. You don’t say how long ago your surgery was….. but if you are allowed to sleep on your stomach again, then you should be fine to include breast play in your sexual repertoire. Remember that it is YOUR tissue that has been used to create your new breasts and over time (and it can take a long time), your breasts should regain some sensitivity…. some women report that they feel ‘electric shocks’ in their reconstructed breasts for YEARS after the surgery. Altered sensation can be scary for women who have been treated for breast cancer because they usually panic and think that what they are feeling is related to cancer coming back. I would suggest starting off with gentle breast play and it is important to tell your partner what YOU feel and what feels good – and not good. Heavy pressure may not be comfortable for a while….or ever.

Women who have had implants are often instructed to massage their breasts using quite a lot of pressure to reduce the build-up of scar tissue.

In answering this question I searched the medical and plastic surgery literature to see if this has been studied or if there are any websites with specific information about this – and I came up empty handed! It is a real pity that you feel that you can’t ask the surgeon about this – he/she should be talking about this routinely with their patients because if you have a question, it is a pretty good bet that most women would want to know this too!

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer – and all the things that happen to your body, relationships, and sex during and after treatment.  Are you a young adult cancer survivor?  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.