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Bellisse

Who We Are

Vision

Bellisse was formed to meet the needs of women suffering from chest and breast lymphedema through the creation and distribution of the patented Compressure Comfort® Bra , the first ready-to-wear compression bra for truncal lymphedema. Lymphedema is a complication that sometimes follows breast cancer diagnostic procedures, surgery, or treatment.

Who We Are

Image: Lesli Bell, PT/CLT-LANA Lesli Bell, PT/CLT-LANA, is a certified physical therapist who has owned and operated a thriving outpatient physical therapy clinic for numerous years in Burlington, Vermont and recently opened another office in Winooski, Vermont. Extensively trained in the treatment of lymphedema and other post breast cancer issues, Lesli specializes in caring for women living with these conditions.

 

Image: Lisa Lindahl Lisa Lindahl invented the Jogbra®, the original sports bra that transformed the lives of female athletes. Today one of the first Jogbras is in the Smithsonian Institution as well as the Metropolitan Museum of Art's Costume Collection where it is touted as a "revolutionary piece of women's underwear, circa 1977". After selling the Jogbra® company in 1990, Lisa had long said that she would not start another business unless it was a "path of the heart..."

Lesli Bell showed her that path.

Innovation - Could it be another revolution?

Despite seeing a dramatic increase at her practice in the number of women suffering from truncal lymphedema, Lesli found that there were no chest compression garments available to help them.

Driven by her deep concern for her patients and her growing frustration at their lack of options, Lesli, an experienced seamstress, decided to address the problem herself.

At first, Lesli attempted to modify athletic bras. But she found the results inadequate to her patients' needs, and sizes too limited. Then she called some manufacturers trying to spark their interest in collaborating with her on creating a more specifically designed product. Her calls fell on deaf ears.

Lesli knew that the woman who had designed and invented the Jogbra® lived in her area. She joked, "I should meet her...If only I could meet the Jogbra Lady!"

Image: Lesli and Lisa together, from left to rightThen, one day, it happened. Lesli was listening to a presentation about employee benefits when the speaker told an anecdote about his wife's business history with...Jogbra® Sports Bras! Lesli nearly jumped out of her chair. Names and telephone numbers were exchanged, and when the two women finally met, lightning struck. Lesli's idea struck Lisa's imagination and her heart. Lisa's know-how and encouragement lit Lesli's entrepreneurial fire. They were on their way, fast friends and business partners.

Combining Lisa's design skills with Lesli's understanding of the issues faced by lymphedema sufferers, they soon created the Compressure Comfort® Bra, a unique, patented garment designed to provide comfort to the hundreds of thousands of women who suffer from chest and breast lymphedema. Lisa and Lesli then formed Bellisse®, a company dedicated to bringing their product to women in need.

It may not ever end up in the Metropolitan Museum of Art's Costume Collection, but in the world of women's compression garments, it is another revolution.

Thank you for taking the time to learn about Bellisse®. We are proud of our mission, committed to comfort and thrilled to share our product and information with you.

How Treatment Issues Informed the Design Process:
A Conversation with Lesli Bell

In a recent interview, Lesli Bell recalled the frustration and concern for her patients that led her to design the Compressure Comfort® Bra, and spoke about the various treatment issues it was designed to address.

Lesli learned much of what she knows about treating chest and breast lymphedema through conversations with other health care providers who were facing similar challenges. We invite you to continue the dialogue with Lesli by sending us stories and case histories of your own experiences with treating chest and breast lymphedema patients.

Q. Why is the Compressure Comfort® Bra identified on the order form as the "style # 'Suzanne'"? Can you tell me who inspired that?
LESLI — Suzanne was one of my very first patients, and she came in with something that she called a "migraine in her chest." I had not heard of this before; I had not been taught that breast or chest edema was as significant a problem as arm edema. Suzanne couldn't tolerate having a hug from her husband; she couldn't stand anybody to bump her. She wanted a shield, a plastic shield, around her, because the pain was so great. And it had been going on for about a year. No one had considered that she might have true lymphedema because she had never had axillary dissection, which is one of the major variables that contribute to chest and breast lymphedema. She had only had a lumpectomy with radiation.
I treated her the first time with traditional manual lymphatic drainage (MLD) therapy and she had about 90% relief of pain. Everybody was shocked and amazed, including myself. I started calling my colleagues and mentors across the country and asking, "Is there something special that you do for this? What else can you do for this? And what compression garment do I use?" I'd just finished my certification training and had learned that you have to use compression with MLD or you don't get a lasting effect. They all said, "What garment? There is no garment. We just tell them to wear a tight bra or a sports bra." And I thought that was a little odd. As I continued treating patients, patients with chest and breast edema came along more frequently. I became very frustrated, and was waiting for someone to come up with something to provide the compressive support I knew they needed, but year after year nothing new appeared on the market. I started talking to my patients about how the Jogbra® could provide some therapeutic benefit because it had some of the "right stuff", but it wasn't the right shape and it didn't have all the right features.
Q. Were you in fact taking some products that were on the market and "jerry-rigging" them to help your patients?
LESLI — Yes, I was cutting them up and sticking prostheses in them and showing patients how they could alter straps to try to make them work ... but they only helped if the patient was a small or medium size. I even wrapped patients with ten-inch bandages and masking tape. This worked for short periods of time, but it was not a solution a patient could sustain nor be comfortable with on a daily basis.
Q. Were breast and chest lymphedema recognized by the medical community?
LESLI — Not really. There's not yet an objective measurement for it. Lymphedema therapists can feel lymphedema when it's there, and sometimes it is even visible. Sometimes the skin gets hot and pink and there may be dimpling of the skin, and sometimes there can be mild to severe fibrosis. Usually, though, the visual signs are subtle, and often these complications are attributed to post-radiation effects. As a result, many less experienced practitioners often miss lymphedema in the chest and breast area.
Q. So often the only thing you have to go on for diagnosis of breast and chest lymphedema is when women say, "I feel really, really uncomfortable"?
LESLI — Well, the symptoms are consistent with chronic edema and lymphedema. However, one of the biggest differences between breast edema and arm edema is that breast edema, in my experience, is generally quite painful. Patients have described the feeling to me as being similar to engorgement when you're breastfeeding. Arm edema is not really as painful a condition, although it is uncomfortable. This difference in symptoms can be confusing to the medical community and as a result, breast lymphedema is often misdiagnosed as an infection. The problem, though, is that lymphedema, if left untreated, can actually lead to exactly that — an infection. So the edema really needs to be diagnosed and controlled, not only for comfort, but also for infection prevention.
Q. If you can't measure this condition, how did you know how to make a garment?
LESLI — Using compression with arm edema is well documented in the literature. It is the treatment of choice to accompany MLD, and it improves the control of the problem dramatically. It makes sense that if you have an edema problem anywhere else, including the breast and the trunk, that compression would also be necessary. Anecdotally, we know that compression decreases patients' chest/breast discomfort. So how do we know how much compression is therapeutic?
We go by comfort. We have found that using a fabric that has a lot of spandex in it, and providing adjustability in circumferential pressure via three hooks, creates significantly more comfort.
Q. How did you meet Lisa Lindahl?

LESLI — I kept waiting for someone to come out with something, because everyone involved in lymphedema therapy must know about this problem. But there still was no research being published on it and no solution. So that's when I started joking with my patients that I just needed to meet "that woman" who invented the Jogbra®.
Q. And Lisa Lindahl just happened to live close to you…
LESLI — Much to my surprise she lives about 20 minutes away from me! I didn't even know what her name was. But the stars met!
Q. And so you sat down with her and talked about how a garment might be put together?
LESLI — Yes, and with her knowledge in the areas of design, manufacturing, and specialty fabrics for sports bras and mine about the challenges inherent in the condition, well, it was a natural combination of expertise. Therapists agree there are about seven problem spots for chest and breast lymphedema patients, and Lisa and I knew that together we could come up with a garment that would address them.
Q. And the seven problems are?
LESLI — First, there is often swelling in the axilla, so the bra needs to come up higher in the axilla than a regular bra.
Second, the bra needs to have better coverage in the back, so that you have close to equal support in the back and the front. You don't only want lift, but also compression, so you don't end up trying to bear all the weight of your chest in your shoulders. If you have lymphedema, one of the important alternate places to drain fluid is into the lower lateral neck. When you have a narrow strap bearing significant weight there, it's cutting through a major area that can accept the fluid that your axilla cannot accept any more.
Q. So a narrow strap is getting in the way...
LESLI — Getting in the way - it's actually cutting off drainage! But back to the list of seven problem spots.
Three — the bra needed to be longer in the front so it didn't cut into the torso.
Four — It needed to have adjustability in the back, because people have good days and bad days, depending on heat, humidity, riding in airplanes, etc. We figured out that we could have three rows of hooks, so more than one amount of tension/compression would be available. Patients can decide what's comfortable for them.
Five — It needed to have wide padded straps that didn't dig. The straps had to be adjustable (many of the sports bras don't have adjustable straps).
Six — The bra needed to zip up the front, so women can get in and out of it easily, after adjusting the back for proper tension.
And seven — We wanted something that would hold prostheses, so we put a pocket into the interior design.
And finally — this was not really on the therapists' list, but definitely on my patients' minds — we wanted to create a bra that patients could wear confidently under everyday clothing.
Q. Has the bra increased the amount of time your patients can wait between treatments? Has it made their home care treatments a lot better? Does it facilitate exercise?
LESLI — The bra has done all of the above. I have many patients who wear the bra and don't need as many sessions of MLD. They have more independent control and management. I have one patient who forgot it when she went away on a trip. She came back with a significant increase in her problem which prior to that she had been maintaining rather well through self manual lymphatic drainage and wearing the bra. When she stopped wearing the bra her problem was greatly exacerbated again. Upon her return from her trip, she had to come in for some concentrated sessions. We were able to get her problem back under control, and now she's wearing the product again, doing her own self drainage and living comfortably. In my experience, patients don't need as much maintenance treatment with the bra — they can manage their condition more independently, and it also helps them with activity and exercise. I've been told by patients that the bra gives them independence, it gives them comfort, it gives them an improved quality of life, and it increases their ability to follow through with the activities of daily living. For some patients, it allows them to be out of the house for more hours during the day, because there are many patients who can't wear conventional bras at all — it's just too uncomfortable. The bras aren't long enough — they cut through the middle part of the chest where there's increased swelling. But with this product, they get to be out and about more frequently than they could before.
Q. So, what other research would you like to see? By designing this bra, you've made a major contribution to the comfort of patients with chest and breast lymphedema. Where would you like to see things go now?
LESLI — Well, the first thing I'd like to see is some sort of prevalence study so we have an idea of how many patients are out there suffering with this problem. I think the second challenge would be to figure out some way to objectively measure the problem, and then understand what a therapeutic amount of compression would be for this specific area. For arm and leg lymphedema, we know that to achieve a therapeutic effect there are certain compression thresholds that have to be met based on the severity of the condition, but we don't know these figures for the chest wall.
Q. Why didn't you wait until research had been done before bringing out this product, so that you could say, "It delivers X amount of compression, which is the medically necessary amount?"
LESLI — Because if we waited for the research to be completed — if it were ever initiated at all —, it could have been anywhere from three to five years, and there would have a lot of people out there suffering much longer, needlessly. Hopefully, Bellisse is creating awareness about the problem of chest and breast lymphedema, and research will follow. In the meantime, creating more comfort is a great place to start. We're trying to help people manage their condition independently for longer, in between sessions with their therapist...and increase their quality of life.
Q. Back to Suzanne, who couldn't be hugged. Did the bra enable her to embrace people more comfortably?
LESLI — For those patients whose torsos are so tender that they can't be touched, if you can reduce and control the lymphedema, which may control the pain, then yes, they can enjoy a hug. That's what happened with my patient Suzanne -- she could enjoy having people spontaneously give her a hug.
In fact, she gave me a hug just the other day!