Many women who plan or undergo a unilateral mastectomy (removal of a breast) have the option of reconstructive surgery to reshape the breast, or a breast prosthesis (an artificial breast). This article is the third in the series, "After Treatment for Breast Cancer" and examines the option of using a breast prosthesis after surgery. For an overview of concerns that women often face after a mastectomy, read the Cancer.Net Feature: After a Mastectomy: What to Know.

About a breast prosthesis

An external breast prosthesis is an artificial breast form, and it is one option for a woman who does not plan to have reconstructive surgery or decides to have breast reconstruction at a later time. The breast prosthesis can be worn after a mastectomy to help balance the body and anchor the bra on the side of the mastectomy, preventing it from riding up, which helps prevent back and neck pain and a sagging shoulder. Breast prostheses are custom-made for most women and are made from several different types of material (such as silicone gel, foam, and fiberfill) that feel similar to natural breast tissue. They are usually weighted so they feel the same as the remaining breast. Some prostheses adhere directly to the chest area, and others fit into pockets of postmastectomy bras, which are fitted with pockets on the inside to hold the device in place. Prostheses may also include features such as an artificial nipple or special shape, depending on a woman’s preferences.

Types of prosthetic devices

External silicone breast prosthesis. This type of device is made of silicone and is designed to model natural breast tissue. The device is weighted to help prevent shoulder drop and poor balance.

Nonsilicone breast prosthesis. This prosthesis is a lightweight breast form made of foam or fiberfill and can be worn right after a mastectomy. It can also be worn during exercise, swimming, and in hot weather.

Attachable breast. An attachable breast is fastened to the chest wall using adhesive strips.

Postsurgical soft-form camisole. A postsurgical camisole is made of a soft, stretchy material with lace elastic straps and is often worn immediately after a mastectomy, lumpectomy, radiation therapy to the chest, or reconstructive breast surgery. A lightweight, removable soft breast form can be placed into a pocket in the camisole.

Partial breast prosthesis. Also called an equalizer or enhancer, this device is made of foam, fiberfill, or silicone. It's designed to be worn over a woman's own breast tissue to create a fuller appearance after a part of her breast is removed, as in the case of lumpectomy.

Choosing breast prosthesis as an option

Choosing to wear a breast prosthesis is a personal decision. Many women select the option because they want to have the same symmetry when wearing clothing as they had before their surgery. A prosthesis offers these advantages as well.

• Protects a woman's chest and surgical scars
  
  
• Helps balance a woman's posture
  
  
• Keeps the bra from shifting side to side or riding up
  
  
• Helps prevent problems with curvature of the spine, shoulder drop, and muscular pain in the neck and back
  

Being fitted for a prosthesis

After the surgical site is completely healed, which typically takes between four and eight weeks, fitting for a prosthesis can take place. Many mastectomy boutiques and specialty shops carry prostheses and postmastectomy bras and camisoles and are staffed by certified fitters who are specially trained to fit women for breast prostheses. At the first fitting appointment, it's recommended that a woman wear a form-fitting garment such as a knit top so she can see how the shape and size of the breast form matches the other breast. With the proper fitting, a prosthesis is undetectable to observers. Some mastectomy shops will even sew pockets into women's regular bras, swimsuits, and nightgowns.

Some insurance carriers will cover the cost of the breast prosthesis and mastectomy bra as long as a woman has a prescription from their doctor. Generally, Medicare and some insurance plans will pay for one silicone breast prosthesis every two years or one to two foam forms every six months and two to four mastectomy bras a year, although mastectomy bathing suits are usually not covered by insurance. If an insurance company does not routinely cover a prosthesis, it is sometimes useful to petition coverage. During Breast Cancer Awareness Month in October, many mastectomy specialty shops hold sales of these items. A woman should check with her insurance carrier before being fitted for a breast prosthesis to determine what is covered under their plan. On average, prostheses need to be replaced every one to two years and postmastectomy bras need to be replaced every three months to a year.

More Information

Cancer.Net Feature: After Treatment for Breast Cancer: Breast Reconstruction

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