Breast prostheses & reconstruction

Tuesday 1 July, 2014

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On this page: What is a breast prosthesis? | What is a breast reconstruction? | Do I need a prosthesis or reconstruction? | Which is right for me? | When can I wear a prosthesis? | When can I have a reconstruction? 


What is a breast prosthesis?

A breast prosthesis (plural: prostheses) is a synthetic breast or part of a breast that gives the appearance of a real breast when worn in a bra or under clothing. The manufacturers usually call them breast forms. Prostheses can be used after the full removal of a breast (mastectomy) or after partial removal (lumpectomy or breast-conserving surgery).

Most breast prostheses have the weight, shape and feel of a natural breast, and they can be attached directly onto the skin or inserted into specially-made pockets in bras, swimwear and nightdresses.

What is a breast reconstruction?

A breast reconstruction is a type of surgery in which a breast shape is created using either a silicone or saline implant, or your own skin, muscle and fat from another part of your body such as your back or tummy (abdomen). Sometimes the reconstructed breast is called a breast mound.

You may choose to have a breast reconstruction at the time of the mastectomy or later.

Although the aim of surgery is to make a breast that looks as natural as possible, the reconstructed breast (and nipple, if created) will not look or feel exactly the same as a natural breast. However, many women who have a breast reconstruction are pleased with the result.

Some facts about reconstructed breasts
  • The breast won’t have much or any sensation, as the nerves will be damaged during the mastectomy.
  • A breast reconstructed using an implant won’t change in size over time (for example due to hormones or weight changes). However, a breast made with your own tissue may change shape and size.
  • You can’t breastfeed a baby with a reconstructed breast, as it won’t produce milk.

Do I need to have a prosthesis or a reconstruction?

Deciding whether or not to wear a prosthesis or get a reconstruction after surgery is a personal decision. Reactions to the loss of a breast or breasts vary from woman to woman. Only you can choose what feels right.

You may prefer not to make the decision immediately. Unless you are considering having a reconstruction at the same time as the mastectomy, there is no time limit on when you must decide. Take the time you need to consider your options.

Some women decide against having a reconstruction or a prosthesis. For example, if you had breast-conserving surgery, you may feel that your breast shape didn’t change much. However, there may be a number of reasons why women who have had a mastectomy sometimes choose to use a full or partial breast prosthesis or have a reconstruction.

Replacing the weight of the lost breast

When a natural breast is removed, the body is no longer balanced. This can cause a slight curving of the spine and a drop of the shoulder on the affected side. These changes may lead to lower back and neck pain over time. A prosthesis or reconstruction can help to even out the balance. 

Problems with balance after having a mastectomy can affect women of any breast size.

Creating symmetry when wearing clothing

Most women don’t have identical breasts – the muscle and tissue on each side of the body is different. However, after a mastectomy, these differences are usually more noticeable. A prosthesis or reconstruction may help you feel and look more symmetrical.

Restoring self-esteem

You may find that recreating a more natural appearance with a prosthesis or reconstruction helps to boost your confidence – including sexual confidence – after a mastectomy. For more information about body image and sexuality issues see our sexuality and cancer pages.

Adjusting to the diagnosis and treatment

Reconstruction or using a prosthesis may help some women cope better with the experience of cancer. You might feel like you are taking control of your appearance.

Which is right for me?

You may find it helpful to consider the advantages and disadvantages of both options – see the tables below. You don’t have to choose between the options – you may start off with a prosthesis, then later decide to have a breast reconstruction.

Prosthesis

Advantages

Disadvantages

  • Doesn’t require further surgery, which has risks and recovery time.
  • Can be chosen straight away.
  • Medicare subsidises the cost.
  • Easy to change size (for example, if your other breast changes).
  • Can be worn with different clothes, including during activities such as swimming.
  • Easily replaced if it wears out or is damaged.
  • Can be worn while you’re waiting for reconstructive surgery or during chemotherapy or radiotherapy.
  • Matched to your breast size to correct weight imbalance issues.
  • You may not like the idea of having an artificial breast.
  • Has special washing and storage instructions, so maintenance is required.
  • Needs to be replaced every few years.
  • Costs of mastectomy bras can add up.
  • Changes to your clothes or accessories may be required, to accommodate the prosthesis.
  • May be uncomfortable at times (e.g. heavy, hot or irritating), especially when playing sport.
  • If you aren’t comfortable, may cause you to feel self-conscious or embarrassed.

Reconstruction

Advantages

Disadvantages

  • A breast made with your own tissue is permanent and usually won’t require any further care after it has healed from surgery.
  • Implant reconstructions last 10–15 years or longer.
  • May be reassuring, as the new breast is a part of you. This could increase your self-esteem.
  • Often looks very natural, after the surgical scars have faded.
  • Changes to clothing may not be required, if the reconstructed breast is about the same size as the natural breast.
  • If you have a TRAM flap procedure (see page 47), you may benefit from having a ‘tummy tuck’ at the same time.
  • A reconstruction could be easy to manage in the long term (low maintenance).
  • Requires surgery (involves time in hospital and recovery at home). Several appointments may be needed, depending on the surgical technique used.
  • As with all operations, problems may occur and there is no guarantee of the desired result.
  • Private patients may have to pay extra costs.
  • There may be a waiting period for an operation if having treatment in a public hospital. Even private patients may not be able to have surgery immediately.
  • Scarring or the result could cause you to feel self-conscious.
  • May not change in shape and size over time, unlike the other breast.
  • Risks include the formation of scar tissue (capsular contraction) or accumulation of blood around the implant (haematoma).
  • An implant may need to be redone in the future.

When can I wear a prosthesis?

Although the breast area will be tender after surgery, a soft, light breast prosthesis called a soft form can be worn immediately, usually for as long as you choose.

The soft form can be worn in a bra that has a pocket (post-surgical bra). If the bra is too constricting or rubs against your scar, you can purchase a pocketed crop top or camisole. Because it is light and made from a gentle material, the soft form can be worn during radiotherapy. When you have recovered from treatment, you can be fitted for a permanent prosthesis. You may need to wait up to two months after surgery and for six weeks after radiotherapy to give the skin and other tissue time to heal. However, each woman is different so check with your surgeon or breast care nurse about your waiting time. See more information about prostheses.

My Care Kit

Breast Cancer Network Australia provides a free post-surgical bra and temporary soft form for women who have recently had breast cancer surgery. You can order a kit through your breast care nurse. See more information on My Care Kit. You can also purchase more durable soft forms and post-surgical bras from retail outlets specialising in prostheses. Call 13 11 20 for information on where you can buy these.

When can I have a reconstruction?

Breast reconstruction can be done or started at the time of the mastectomy (immediate reconstruction) or at a later stage (delayed reconstruction). This can be months or years later.

The timing depends on the type of breast cancer you were diagnosed with, whether you need further treatment (for example, chemotherapy or radiotherapy), your general health, and other concerns, such as the cost. For some women, it is important to plan reconstruction from the time of their mastectomy, but other women prefer to focus on the cancer treatment and think about reconstruction later. Sometimes you won’t be able to have an immediate reconstruction due to the surgery schedule at the hospital.

Talk about these issues with your breast cancer surgeon, oncoplastic surgeon and/or reconstructive (plastic) surgeon. If you have concerns, it’s okay to get a second opinion from another specialist.

See more information about breast reconstruction.

"I wore a breast form for six years and then decided to have a reconstruction. After the diagnosis, all I wanted was to have the tumour removed and save my life. Now I'm tired of wearing and maintaining the form." — Sandra
 

Reviewed by: Christobel Saunders, Breast Surgeon, Royal Perth Hospital and St John of God Hospital, and Deputy Head, School of Surgery, The University of Western Australia, WA; Gwen Andriessen, Consumer; Jane Marsh, Clinical Manager, Breast Centre, Brian Fricker Oncology Centre, Burnside War Memorial Hospital, SA; Carmen Heathcote and Yvonne Howlett, Cancer Council Queensland Helpline Operators; Lisa Merrill, Consumer; Marie Murdoch, Helpline Operator, Cancer Council Queensland and Breast Care Nurse, The Wesley Hospital Kim Walters Choices Program, QLD; and Jo White, Helpline Manager, Cancer Council NSW.
Updated: 01 Jul, 2014