Managing permanent changes to appearance
If you have permanent changes caused by cancer treatment, there are ways to help you manage these.
About body changes
You will need time to recover from treatment and to adapt to the changes to your body, especially if they are more permanent. There are ways to help you to manage these changes and develop a more positive body image.
If you are struggling with the changes to your body, it is important to get support from your healthcare team, friends and family.
Taking care of yourself and your body is important. It may help you develop a more positive body image.
Permanent changes to appearance
Before treatment, your cancer team should give you information to prepare you. They will tell you how the treatment is likely to affect you and what your recovery might involve. They will also explain different treatment options that will change your body in different ways, such as reconstructive surgery.
Your cancer team can help you make decisions. They can also:
- tell you about possible side effects and what may help, such as cold cap treatment that may help reduce hair loss caused by chemotherapy
- refer you to other members of the team – for example, occupational therapists, physiotherapists or speech and language therapists (SLTs)
- 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 ask your cancer doctor or specialist nurse any questions you have and let them know if you have body image concerns during or after treatment. There are different ways they can help and support you.
Reconstructive surgery
You may choose to have reconstructive surgery after some types of surgery to remove cancer. For example, you may choose to have 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 feel more confident about your appearance. Before you decide whether to have it, it is important to have realistic expectations about the outcome. Your cancer doctor or specialist nurse will explain the possible benefits and disadvantages of reconstructive surgery in your situation.
Breast reconstruction is often done straight away. But if you have a breast removed (mastectomy), you might decide to have reconstruction years later. Your cancer doctor or breast care nurse will talk to you about this. They can refer you to a specialist surgeon.
Treatment for scars
How scars feel and look usually improve in the months after surgery. They gradually fade and become softer.
Sometimes people are unhappy because of how a scar looks, or if it feels tight and uncomfortable. This may cause concerns about your body, and affect relationships and how you feel about being physically intimate with another person.
Tell your cancer doctor or specialist nurse how you feel about the scar.
After surgery, some people might have a scar that overgrows and becomes larger than the original wound. This is called a keloid scar. They can affect anyone but are more common if you:
- have black or brown skin
- had surgery to your upper back, shoulder or chest – this is because of the way the skin stretches across these areas.
There are different treatments that might help reduce scarring, including keloid scars.
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 scars.
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.
You can also use skin camouflage make-up to help make a scar less noticeable
Wearing a prosthesis
A prosthesis is an artificial body part. If you wear any type of prosthesis and do not feel confident, talk to someone from your cancer team. This might be your specialist nurse, cancer doctor or another healthcare professional. If you wear a prosthetic limb, your physiotherapist or occupational therapist may be able to help.
The prosthesis may not be the right fit or type 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. If you have black or brown skin, you may not have been offered a prosthesis that is the right skin colour match for you.
Even if your prosthesis is still in good condition, your cancer doctor or specialist nurse can arrange for you to be reassessed. If you have had the prosthesis for a while, there may be new, improved types available. Or there may be a prosthesis available that is a better match for your skin colour.
Breast Cancer Now has information about breast prostheses and the different suppliers you can get them from. If you have a facial prosthesis, Changing Faces has more information.
Make-up, clothing and accessories to cover up body changes
You may feel more confident if you cover up changes to your body. Different people can help you with this. This includes your healthcare team, who can:
- refer you to Changing Faces for advice about camouflage make-up
- 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 for a new replacement part, such as a breast prosthesis.
Camouflage make-up
A skin graft is skin taken from another part of the body that is placed over the area where the cancer was removed. If you have had skin grafts, the colour may not match your surrounding skin. Or you may have visible scars you would like to cover up. In these cases, 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 to the person who supplied it. They can usually match the colour to your camouflage make-up.
Look Good Feel Better (LGFB)
Look Good Feel Better (LGFB) runs free workshops for people coping with cancer treatment. It has trained volunteer beauty professionals who offer practical advice and support. Workshops are available in over 80 hospitals and specialist cancer centres across the UK. Ask your cancer doctor or specialist nurse for a referral in your area.
Clothing
You can use clothes to feel comfortable and as a way of expressing yourself. If you choose to, you can also use clothing to cover up certain body changes.
Look at the clothes you already have to find what is suitable. Or ask a family member or friend to help you.
Depending on the body change you have, you can get advice on clothing from support organisations:
- Breast Cancer Now
- Changing Faces
- Colostomy UK
- Ileostomy and Internal Pouch Association
- 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 can be more comfortable.
- 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 vest or camisole top underneath.
- High V-neck shirts help if you want to cover a scar or central line in the chest area.
- High band 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 can also draw attention to certain areas and away from others
Artistic tattoos
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 Now has more information about artistic tattoos after breast surgery.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our information about body image and cancer. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Asfour L, Montgomery K, Solomon E, Harries M. PS08: The psychological impact of hair loss and the role of psychological interventions. British Journal of Dermatology. 2021; 185(S1): 172–173. Available from: www.doi.org/10.1111/bjd.20356 [accessed September 2023].
Brook I. Early side effects of radiation treatment for head and neck cancer. Cancer/Radiothérapie. 2021; 25(5): 507–513. Available from: www.doi.org/10.1016/j.canrad.2021.02.001 [accessed October 2023].
Elad S, Cheng KKF, Lalla RV, Yarom N, Hong C, Logan RM, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2020; 126(19): 4423–4431. Available from: www.doi.org/10.1002/cncr.33100 [accessed September 2023].
Riopel L. Goal setting in counseling and therapy (incl. examples). PositivePsychology.com. 2019. Available from: www.positivepsychology.com/goal-setting-counseling-therapy [accessed October 2023].
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