This article examines the option of using a breast prosthesis after surgery. Although many women who choose a mastectomy (removal of the breast) consider reconstructive surgery, others may choose a breast prosthesis. Learn more about the issues a woman faces and the options available after surgery for breast cancer .
What is a breast prosthesis?
An external breast prosthesis is an artificial breast form that can be worn after a mastectomy. It helps balance the body and keeps the bra on the side of the mastectomy from riding up, which helps prevent back and neck pain and a sagging shoulder. Breast prostheses are custom-designed for most women. They are made from several different types of material (such as silicone gel, foam, and fiberfill) that are of similar weight and feel to natural breast tissue. Some prostheses adhere directly to the chest area, while others fit into pockets of mastectomy bras to hold the prosthesis in place. Prostheses can also be made with an artificial nipple or a special shape depending on a woman's preferences.
Types of prosthetic devices
External silicone breast prosthesis. This type of prosthesis is made of silicone and designed to model natural breast tissue. The prosthesis is designed to weigh the same as the natural breast 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 (after surgery) camisole is made of a soft, stretchy material with lace elastic straps and is often worn immediately after a mastectomy, lumpectomy (removal of the tumor and some tissue around the tumor), 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 prosthesis 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, such as with a lumpectomy.
Being fitted for a prosthesis
After you have completely healed from surgery, which typically takes between four and eight weeks, you can be fitted for a prosthesis. There are many mastectomy boutiques and specialty shops that carry prostheses, postmastectomy bras, swimsuits, and camisoles (see Additional Resources, below) 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 you wear a form-fitting garment, such as a knit top, so you can see how the shape and size of the breast form matches the other breast. With proper fitting, the prosthesis will not be noticeable. Some mastectomy shops will even sew pockets into your regular bras, swimsuits, and nightgowns.
Some insurance  carriers will cover the cost of the breast prosthesis and mastectomy bra, as long as you get a prescription from your 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 for coverage. During Breast Cancer Awareness Month in October, many mastectomy specialty shops hold sales on these items. You should check with your insurance carrier before being fitted for a breast prosthesis to determine what is covered under your 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.
Choosing breast prosthesis as an option
Choosing to wear a breast prosthesis is a personal decision. Many women select this option because they want to look the same when wearing clothing as they did before their surgery. A prosthesis offers these advantages as well:
- Protects your chest and surgical scars
- Helps balance your posture
- Keeps your bra from shifting side to side or riding up
- Helps prevent problems with curvature of your spine, shoulder drop, and muscular pain in your neck and back