A breast prosthesis is an artificial breast form. It gives a breast a more natural shape after a mastectomy or breast-conserving surgery.
The decision to use a breast prosthesis is a very personal one. It is based on your feelings, desires, lifestyle and other factors. You may choose to wear a prosthesis while you decide if you want to have breast reconstruction or while you are waiting for reconstruction surgery. You may also decide to use a breast prosthesis instead of having breast reconstruction. Some women choose not to use a breast prosthesis or to have reconstructive surgery.
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Breast prostheses are sold in stores that specialize in products for women who have a mastectomy. Prostheses and the nipples on the prostheses come in a wide variety of shapes, sizes and colours. Prostheses can be worn with a regular bra or a mastectomy bra. A mastectomy bra has a pocket sewn into it for the prosthesis. You can also adapt a regular bra by sewing a pocket into the cup.
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A temporary prosthesis, or puff, is a soft, light form that can be pinned inside of clothes or worn inside a loose-fitting bra. It is made of material that will not rub or hurt the area of surgery while it heals. You can tuck a temporary prosthesis into the bra cup to provide a smoother shape. A bra extender may make the bra more comfortable until the swelling from surgery goes down.
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A permanent prosthesis is designed to look, weigh and move like a natural breast. It is made from silicone, foam or other materials. Some permanent prostheses attach directly to the skin on the chest with a special kind of glue. Others are worn in a regular bra or a mastectomy bra. A permanent breast prosthesis may feel heavy when you first start to wear it. Wearing it for a few hours a day will help the body adjust. In time, the prosthesis will feel more natural.
You can be fitted for a permanent prosthesis 4–6 weeks after surgery. This time allows your surgical incision to heal and the swelling to go down. When properly fitted, a permanent prosthesis provides balance for good posture. It helps prevent back and neck problems that can develop when a breast is removed. It also prevents the bra from sliding up and gives a natural shape to clothing.
Certified fitters are trained and experienced in fitting breast prostheses. They can help find the best type of prosthesis for you and show you how to use it properly. They can also show you how to take care of your prosthesis so that it will keep its shape.
You may want to take your partner or a good friend with you to give you support and feedback when you go shopping for a permanent prosthesis. Most stores will let you set up a private appointment, which might make the experience more comfortable for you.
When you go to the store, wear or take along a form-fitting top or sweater so it will be easier to see how the prosthesis looks. Try the prosthesis on in a comfortable, supportive bra. Try to match the form as closely as possible to the shape of the other breast from all angles, not just the front. Focus on good fit, comfort and a natural appearance in the bra and under clothing. The form should look good and feel comfortable. It should also stay in place when you move. You may want to ask if the prosthesis can be worn with swimwear and if you need to wear a specially designed swimsuit with it.
The type of surgery you had, where the surgeon made the incision and the shape of your body will affect what feels and looks good. Different stores may carry different brands – it may be helpful to try prostheses at more than one store. If you can’t find a prosthesis that works for you, you can have a custom one made.
The cost of a permanent prosthesis may be covered by your provincial or territorial health insurance plans or by personal or work health insurance plans.
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Most women who have breast-conserving surgery do not need a prosthesis to replace the missing breast tissue. In some cases, the surgeon needs to remove a lot of breast tissue and the breast may look uneven. You can wear a partial prosthesis (also called a shaper, shell or equalizer) over the breast to create a fuller, smoother appearance.
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Many breast prostheses manufacturers also make special bras with pockets in the cups to hold the prosthesis in place. They are made to support the weight of the breast form.
Stores that carry products for women who have a mastectomy usually carry mastectomy bras. A trained fitter can suggest a bra that will fit and support you well. Mastectomy bras are available in a variety of fabrics and colours. Special bras for sleep or leisurewear are also available.
Not every woman needs a special mastectomy bra. You may be able to use a bra you already own. You might just need to make a few adjustments to make it comfortable or sew in a pocket to hold the prosthesis.
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Gallagher P, Buckmaster A, O'Carroll S, et al . External breast prostheses in post-mastectomy care: women's qualitative accounts. European Journal of Cancer Care. Wiley Blackwell; 2010.
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