If you decide that breast reconstruction isn’t right for you but still want a breast shape, a prosthesis, also called a breast form, can help you look balanced without surgery. You can use a prosthesis (or two prostheses, if you’ve had a double mastectomy) if you want the appearance of breasts but want to hold off on reconstruction or not have it at all.
A prosthesis is the fastest way to fill the space where your breast was. You can slip it into your bra or bathing suit and appear as you did before surgery — and this is a big relief for many women, especially after losing a breast and making so many major decisions.
A trained volunteer from the American Cancer Society’s Reach to Recovery program can give you information about prostheses and where to buy them in your area, reconstruction, and other topics.
Breast prostheses come in many shapes, sizes, and materials: silicone gel, foam, or fiberfill interior. Some prostheses are weighted and some are not. One company, Nearly You, actually offers 86 sizes and shapes. Many prostheses slip into a pocket in a specially designed bra or camisole. Others come with adhesive patches that attach to the upper edge of your breast area, allowing you to go braless if you like. Others use magnets: a magnet attaches to your skin with an adhesive patch and the other magnet is on the back of the prosthesis. The breast form snaps onto the magnet on your chest to stay in place. Prostheses that stay in place with adhesive or magnets don't require special lingerie. The adhesive patches last about a week and then you replace them.
If you opt for a prosthesis that uses adhesive or magnets to stay in place, be careful when you apply the adhesive patches to your skin. Most women have no problems, but some people's skin is particularly sensitive after surgery.
There are two main types of breast prostheses, and each may be right for you at different times and for different reasons:
- A lightweight model (polyfill or foam) is recommended when you're recovering from surgery, because it's most comfortable. It also feels good during warm weather and swimming and can be machine-washed. Most lightweight breast prostheses can be worn in chlorinated or salt water.
A silicone prosthesis may look more realistic and feel more natural to you for everyday wear. If you prefer to wear a prosthesis during sex, many women choose silicone prostheses because they have the most natural feel for their partner. Two types of silicone prostheses are available:
- asymmetrical: designed only for the left side or only for the right side
- symmetrical or pear-shaped: these work on either side and can be worn sideways to fill out the side of your bra, or straight up for center fullness and cleavage
Silicone prostheses may seem heavy compared to the foam-filled models, especially for women with large breasts. But the balanced-weight silicone helps keep your shoulders even and your posture straight. Prices range from under $100 to $500 for high-quality products (size is not a cost factor), and they last from 2 to 5 years. Salt water, pool water, and hot tubs may damage the outer shell of most silicone products, making it sticky (and more likely to collect dirt) and thinner (making it more likely to rupture and leak). Check with the manufacturer to be sure. If possible, you may want to avoid using a silicone prosthesis in any kind of water and use a less expensive, lightweight breast form instead. Silicone is hand-washable only.
You can buy a breast prosthesis at a surgical supply store, pharmacy, custom lingerie shop (which usually have trained fitters), or a private service that comes to your home. You may want to try out samples under different clothes — from sweaters and t-shirts to suits and slinky formal wear — to make sure it's right for all aspects of your lifestyle. Make sure to ask your fitter the best way to wear the prosthesis based on your unique situation, body type, clothing, and activities.
Some specialty shops sell custom-made breast prostheses, individually constructed and cast to match the natural contours and color of your body and your other breast. These are usually made from silicone or latex and are significantly more expensive than a breast prosthesis that isn't custom-made. Many insurance companies don't cover custom-made breast forms. A plaster cast or laser scan is taken of your chest and then the prosthesis is contoured so it fits snugly against your body.
Special clothes that fit a prosthesis
Bathing suits and lingerie designed for women who have had mastectomies are available by catalog or online from a number of retailers, including Sears, Lands' End, JCPenney, and specialty shops. The clothing comes with a pocket to hold the prosthesis. You can also have pockets sewn into the bras or suits you already own. If you decide to buy a custom-made prosthesis, you probably won't need special clothes or bras.
Insurance coverage for a prosthesis
It's important to have your doctor write a prescription for your prosthesis so you'll be reimbursed by your insurance company if prosthetics are covered by your plan.
Before you buy or are fitted for a prosthesis, be sure to check with your insurance company to find out exactly what is covered for your recovery and rehabilitation. Plans can vary, but most typically cover:
- two to four special mastectomy bras (with prostheses pockets) each year
- a new prosthesis every 1-2 years
If you apply for insurance coverage for a prosthesis, your coverage will not be affected if you decide to have breast reconstruction later.