Choosing a Prosthesis After Breast Cancer Surgery

Topic Overview

Whether to wear a breast form (prosthesis) after breast surgery is a very personal decision. Some women feel better about themselves when their clothes fit just as they did before surgery. Other women feel comfortable just as they are.

You can buy these forms already made, or they can be custom-made from a mold of your chest.

You may want to wear a breast form if:

• You are waiting for reconstructive surgery.
• You have decided not to have reconstructive surgery.
• You have had reconstructive surgery, but your breasts don't look even.
• You have had only part of your breast removed (lumpectomy).

What kinds of prosthetics are used after breast surgery?

A wide variety of breast forms and accessories-from mastectomy bras to stick-on nipples-are available to a woman who has had one or both breasts removed or who has had part of a breast removed. They come in many different shapes, colors, and materials, depending on what you need.

• Breast form shapes
  • Full. A full breast form can be used to replace an entire breast.
  • Partial. This form is for use by a woman who has had breast-conserving surgery. She may want a partial form to fill out that side of the bra.
  • Shell. This form is hollow and fits over the breast tissue. A woman's reconstructed breast may not look exactly like her other one. She may want to use a shell on either the reconstructed breast or the natural breast to make the chest look more balanced.
  • Nipple only. This artificial nipple sticks onto the reconstructed breast when reconstruction does not include a nipple or you just don't like the way the new nipple looks. It can also be stuck onto a breast form that does not have a nipple.
  • Nipple cover. This can be used to cover a natural nipple when you don't want it to show through clothing. Sometimes reconstructed breasts don't have nipples, so you can use a nipple cover on your other breast to create a more balanced look.
• Breast form materials
  • Silicone. This is the most expensive type of breast form. It looks and moves more naturally than other breast forms. It is also heavier than cotton or other material. Silicone breast forms can make your skin feel hot and sweaty.
  • Fiberfill or foam. These are lighter and cooler than silicone. They also cost a lot less. They don't look as natural under form-fitting tops, but they work well for lounging at home. They also work well if your breast is still healing from surgery.
  • Homemade. Many women use things they already have in their closet-from a shoulder pad to a wad of nylons-to fill out their bra cup. If you always wear loose-fitting tops that don't reveal your breast shape, a homemade breast form may be all you want.
  • Waterproof or water resistant. You can wear most breast forms when you swim, but many of them soak up water and get quite heavy. If you swim a lot, you might think about getting a special breast form just for swimming.

Custom-made breast forms

A custom-made form is made by making a mold of your chest area so that the form will fit your chest and body exactly. Because of the extra work involved, custom-made breast forms cost much more than ready-made forms. Your insurance may not cover this extra cost.

Your local American Cancer Society chapter can help you find companies that make custom-made breast forms. You can also find companies on the Internet.

Accessories

Breast forms can be worn with regular bras, but you may have trouble keeping them in place. You can make or buy pockets that you sew into your regular bras to keep the form from moving around.

Or you can buy mastectomy bras. These special bras now come in almost as many styles and colors as regular bras do. They have built-in pockets to hold all types of breast forms.

Some breast forms can be attached directly to the skin, using special glue or tape. They can stay on for several days at a time.

There are many styles of swimsuits now for women who have had breast surgery. The suits have built-in pockets for breast forms.

Check to see if your insurance will cover the cost of a prosthesis and mastectomy bra. Many policies do.

What are the benefits of getting a breast form?

• Some women feel much better having both sides of the chest match under their clothes.
• A breast form may help your clothes fit better or help your bra stay in place.

What are the disadvantages?

• Breast forms require some maintenance. They need to be washed regularly and stored properly. They need to be rinsed out after you swim in chlorinated or salt water.
• They can be expensive if you don't have insurance.
• You may feel less comfortable in revealing clothes than you might if you had reconstructive surgery.
• Breast forms that are glued to your skin can make your skin feel very warm. Some women find that their skin is sensitive to the glue, especially after radiation treatments.

How soon can you wear a breast form?

• There are soft, weightless forms that you can wear right after surgery while your scar heals.
• Silicone breast forms typically aren't worn until the area has healed (usually 6 to 8 weeks after surgery).
• You may need to wait even longer to wear a silicone form if you have radiation treatment after your surgery. Radiation can make wearing a silicone breast form uncomfortable, because your skin may be extra sensitive.

Where can you get a breast form?

You can find breast forms at most surgical supply stores and lingerie stores-and even the lingerie departments of some department stores. Breast forms can also be purchased over the Internet.

Most experts recommend getting the help of a trained fitter. When you go for a fitting, wear a close-fitting top so that you can really see how the breast form looks and moves.

Take a partner or good friend with you for a second opinion and support.