Choosing a Prosthesis After Breast Cancer Surgery

Overview

Whether to wear a breast form (prosthesis) after breast surgery is a very personal decision. You may want to wear a breast form if:

• You are waiting for reconstructive surgery.
• You have decided not to have reconstructive surgery.
• Your breasts don't look even.
• You have had only part of your breast removed (lumpectomy).
• You're waiting for a breast reduction on the side without cancer so your breasts look even.

Types of breast prosthetics

A wide variety of breast forms and accessories are available. They come in many different shapes, colors, and materials. You can buy these forms ready-made, or they can be custom-made.

Breast form shapes include:

• Full. A full breast form can be used to replace an entire breast.
• Partial. This form may be used after breast-conserving surgery to fill out that side of a bra.
• Shell. This hollow form fits over the breast tissue. A reconstructed breast may not look exactly like the other one. A shell can be used on either the reconstructed breast or the natural breast to make both sides look the same.
• Nipple only. You can use an artificial nipple on a reconstructed breast that doesn't have a nipple or if you don't like the way the nipple looks. It can also be used on a breast form that doesn't have a nipple.
• Nipple cover. This can be used to cover a natural nipple when you don't want it to show through clothing. If a reconstructed breast doesn't have a nipple, you can use a nipple cover on your other breast to make both sides look the same.

Breast form materials include:

• Silicone. This looks and moves more naturally than other breast forms. It is also heavier than most other materials. Silicone breast forms can make your skin feel hot and sweaty.
• Fiberfill or foam. These are lighter and cooler than silicone, and they may also cost a lot less. They may not look as natural under form-fitting tops. They may work well if your breast is still healing from surgery.
• Homemade. You can also fill out a bra cup with things you already have in your closet, from a shoulder pad to a wad of nylons.
• Waterproof or water-resistant. You can wear most breast forms when you swim, but many of them soak up water and get heavy. If you swim a lot, you might think about getting a special breast form for swimming.

Custom-made breast forms may be an option. A custom form is made from a mold of your chest area so that the form will fit your body exactly. But custom-made breast forms cost much more than ready-made forms. Some insurance plans may not cover this extra cost.

You can look online to find companies that make custom breast forms.

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.
• Mastectomy bras, which have built-in pockets to hold all types of breast forms. Many insurance policies will cover the cost of a mastectomy bra.
• Swimsuits. There are many styles of swimsuits that have built-in pockets for 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.

Pros and cons of breast forms

Pros include:

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

Cons include:

• 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.
• Breast forms that are glued to your skin can make your skin feel very warm. Some people find that their skin is sensitive to the glue, especially after radiation treatments.

When to start wearing 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.

Finding a breast form

You can find breast forms at most surgical supply stores and lingerie stores and in the lingerie department of some department stores. Breast forms can also be purchased online.

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.

You might want to take a partner or good friend with you for a second opinion and support.