Breast prostheses

Tuesday 1 July, 2014

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On this page: Material used in prostheses | Types of prostheses | Buying a breast prosthesis | Wearing a breast prosthesis | Caring for a breast prosthesis | Costs and financial assistance | Air travel with a prosthesis | Question checklist | Key points  


Material used in prostheses

Most breast prostheses for long-term use are now made from a solid type of silicone gel. They are moulded into the natural shape of a woman’s breast or part of a breast.

Temporary forms tend to be made with foam, fibrefill or fleece; these are usually worn in the first couple of weeks or months after surgery. Some women continue wearing a soft form at nighttime.

The top and front surface of a permanent breast prosthesis feels soft and smooth. The back surface that rests against your body varies and depends on whether the prosthesis is designed to go into a bra pocket or stick directly to your skin. It can be firm and smooth, flat or hollow, have ridges that are soft and flexible, have sticky (adhesive) spots, or be made of fabric.

Most permanent prostheses are weighted to feel similar to your remaining breast (if only one breast has been removed), but lightweight styles are also available. Some prostheses include a nipple outline, or you can buy a nipple that sticks to the form.

What is silicone?

Silicone is a non-toxic, synthetically-made substance that is heat resistant and rubbery.

This makes it useful for moulding to the shape of a natural breast and placing next to the skin. If a prosthesis tears or punctures, the silicone can’t be absorbed by the skin. 

"Breast forms are very well designed these days. Anyone pressing up against you would not know the difference - not like the days when they were filled with bird seed or rice." — Jan

Types of prostheses

Every woman’s body is different so there is a large range of prostheses available in various shapes (triangles, circles or teardrops), cup sizes (shallow, average, full) and skin colours. There are also partial breast forms (triangles, ovals, curves and shells) for women who have had breast-conserving surgery or a reconstruction and want to fill out their breast shape.

Different prostheses have different amounts or layers of silicone. This allows women to match the breast form to the structure and movement of their remaining breast.

Some prostheses are even on both sides (symmetric) or uneven (asymmetric). Symmetric forms can be worn on either side of the body; asymmetric forms are either worn on the right side or the left side.

The type of prosthesis you can wear will depend on the amount and location of tissue removed during surgery. You should be able to find one that is close to your original breast shape and suits your lifestyle. Your fitter will be able to guide you through the range of prostheses that are suitable for you.

Soft breast form
Breast prosthesis: Soft breast form

 

This light breast form usually has a polyester front cover and a cotton back cover. It is mainly used in the weeks immediately after surgery and is good if you have sensitive scar tissue or if you want to wear a form in bed. It can also be used for swimming, although there are other forms more suitable for this purpose.

Due to their light weight, soft forms are not suitable if you need a prosthesis for balance (to even up the weight of the breasts).

 

Basic breast formBreast prosthesis: Basic breast form

 

This is a full breast form with a natural curve and weight that helps fill the bra cup completely. The form is made as a single mould using one layer of silicone only. It tends to be heavier than other types of forms.

There are different sizes and shapes for you to get the best fit and comfort. Many have a nipple shape styled into the silicone.

 

Two-layer breast form

Breast prosthesis: Two-layer breast form

 

Two-layer breast forms are made with two different layers of silicone. This gives the form a more natural drape depending on the type of breast it is matching – for example a younger breast, an older breast, or a smaller breast. The layering also helps the breast form have a more realistic movement.

They are lighter than basic forms but heavier than lightweight forms. Some two-layer forms include temperature control technology.

 

Partial breast form or shaper

Breast prosthesis: Partial breast form or shaper

 

If surgery or radiotherapy has changed your breast shape significantly (e.g. part of it was removed), you can use a small, specially shaped breast form. This will fill out your bra and achieve symmetry.

Some prostheses are filled with machine washable fleece to obtain the desired size. Certain brands of partial breast forms stick directly to the skin, so they can be worn with a regular, non-pocketed bra. You can also place the form in a pocketed (mastectomy) bra.

 

Shell breast formBreast prosthesis: Shell breast form

 

A shell breast form is a type of partial breast form. It is hollow (concave) and fits over any remaining breast tissue to restore your breast to its original shape and size.

Sometimes women who have had a breast reconstruction find that the size of their remaining breast changes if they gain or lose weight. They can use a shell breast form to make their reconstructed breast match the size of their natural breast.

 

Lightweight breast form
Breast prosthesis: Lightweight breast form

 

Lightweight breast forms are made with a lightweight silicone and are about a third lighter than a basic breast form.

Lightweight breast forms are useful for women with lymphoedema, osteoporosis or arthritis, or for women with larger breasts. Some lightweight breast forms include temperature-control technology.

 

Attachable or contact breast form

Breast prosthesis: Attachable or contact breast form

 

While many breast forms are designed to be worn in a bra pocket, others stick directly to your skin. You may find that this looks and feels more natural. You will still need to wear a well-fitting bra.

"Because the attachable form sticks to the skin it feels normal and natural, just like my lost breast." Peggy

 

Swim breast formBreast prosthesis: Swim breast form

 

Some women prefer to swim without their breast form or to use a soft form, but if you swim often, there are advantages to buying a swim form. They are made with silicone that retains its shape in and out of the water, and they are resistant to chlorine and saltwater. Swim forms are much lighter than regular prostheses, dry quickly and can be worn in a pocketed swimsuit.

Some manufacturers don’t recommend wearing a silicone form in a sauna or spa because it may heat up against your skin. Try a foam or fibrefill one instead.

 

Buying a breast prosthesis

It is recommended that you see a trained fitter who can help you choose the right prosthesis, as well as a mastectomy bra, if necessary. You will need to call ahead and make an appointment. This allows you to have uninterrupted time with the fitter.

For some women, having a fitting can be an emotional or distressing experience, especially the first time. You may be embarrassed at the thought of having another woman see the site of the surgery, or feel upset about needing a breast prosthesis. Remember that the professional fitter regularly sees women who have been in a similar situation, so she takes a sensitive approach.

When you go to the fitting, you might like to take a friend with you for support. The other person doesn’t have to come into the dressing room with you.

You may also find it helpful to see some breast forms before your appointment (or even before your operation), to give you an idea of what to expect. Ask your breast care nurse to show you samples of breast forms and bras. You may also benefit from talking to a woman who is using a breast prosthesis. See information about volunteer peer support.

See a list of questions you might like to ask your breast care nurse or a breast prosthesis fitter and information about costs

Where to buy a breast prosthesis

There are some specialist stores that only sell breast forms and associated products. The lingerie section of some major department stores and lingerie boutiques also have trained fitters. There may also be a free home service available in your area.

If you live in a rural area, you might have fewer options for what you can buy and where you can shop. Making a trip to a shop in a large town or city may be beneficial. This might also appeal if you don’t want to shop where people know you.

You can also shop online or ask retailers to send catalogues so you can look at the full range of bras and breast prostheses available. If you see something you like, you may be able to order it, or a fitter can order it in for you. However, it is recommended that you go to a fitter to be seen and measured in person, particularly if you are buying your first one.

Call Cancer Council 13 11 20 for a list of stores where you can purchase breast prostheses, mastectomy lingerie and accessories.

Choosing a bra

It is important for your health and comfort that the prosthesis and bra fit correctly. Having a well-fitting bra will ensure your breast prosthesis is comfortable and fits well.

You can bring your own bras (regular, post-surgical or mastectomy) to your fitting or your fitter can suggest a bra from their stock.

The bra holds the prosthesis and protects it from damage. It also supports and shapes the remaining breast, which is used to determine the size of the breast form. A bra that is supportive and fits well:

  • may have underwire, if this is comfortable for you
  • needs full cups with firm, elasticised edges
  • should sit close to your chest wall between the cups and have a high front at the centre
  • should have elasticised, adjustable, comfortable straps
  • should have reasonably thick sides that don’t cut into the skin
  • minimises slipping or movement of the prosthesis.

A tight bra or one that has narrow shoulder straps may obstruct the flow of lymph fluid in your body and cause swelling in the arm (lymphoedema). A good fit will reduce the chance of this.

While some women find that their ordinary bra, sports bra or sports crop top adequately supports their prosthesis, mastectomy bras are specially designed for this purpose. As well as being cut wider under the arm, across the chest and in the straps, mastectomy bras have a pocket in the cup to hold the prosthesis in place. The material is also wide enough to cover an attachable or contact form. There are many attractive designs available.

If you choose to use a regular bra, you can buy or make a pocket to sew into the bra to hold in the prosthesis. A bra pocket pattern can be downloaded here

At the fitting

A fitting normally takes 40–60 minutes. Most fitters carry out the fitting in a similar way:

  • The female fitter checks your bra size with a tape measure.
  • The fitter will ask you about what type of bras you like and how active you are, or will check if your own bras are suitable.
  • If you’ve had a double mastectomy, the fitter will ask you what breast size you were and what size you would like to be. You might like to keep your original size or go up or down a size.
  • The fitter brings you a selection of bras to choose from.
  • When you’ve chosen your bra, the fitter will help you try on different prostheses until you find a good fit.
  • The fitter often has a slip-on T-shirt (like a smock) for you to try over the bra and prosthesis to check that the form is the right size and looks symmetrical under clothing. You can put your own clothes on, but many women find the T-shirt easier.
  • The fitter then shows you how to make sure the prosthesis sits properly in the bra and how to take care of it.

You will have privacy when being measured and getting changed during the fitting.

Getting the right fit

The key to a well-fitting breast form is getting it to match your natural breast as closely as possible. Breast form design has improved over the years so that they appear realistic. With a correctly fitting prosthesis and bra, it is very unlikely that a form will fall out or be noticeable to others.

Aim for a fit that looks natural and feels comfortable. The various styles and materials used in making the forms may feel quite different on your skin or in the bra. This will help you decide which prosthesis is best for you.

Ideally, you will get used to wearing the prosthesis, whether it sticks to your skin or is in a bra pocket, although this may take some time. If the breast form feels uncomfortable or looks obvious, it is probably not the right fit.

Questions about the fit
  • Is the bra comfortable when I take a deep breath?
  • When I lean forward, is the bra sitting flat against my chest?
  • Does the prosthesis feel secure in the bra?
  • Does the prosthesis blend in with my skin tone?
  • Do I feel balanced?
  • Can I see edges of the prosthesis sticking out of the top or sides of the bra? (If so, the bra/form isn’t the right fit.)
  • Does the surface of the bra look smooth?
  • Do I like how I look with the prosthesis in place?
Tips for getting a breast prosthesis
  • Wait 6–8 weeks after completing radiotherapy before making an appointment to buy a prosthesis.
  • Ask other women about their experiences, but remember, what suited them might not work for you.
  • Try different types of prostheses to get the best fit and comfort for your body.
  • Don’t be pressured into settling for a prosthesis you’re not entirely happy with.
  • If you are unsure about which breast form or bra to buy, or if you think nothing in the shop is suitable, ask if the fitter can order in other styles for you. You could also try another retailer who may carry different products or a wider range.
  • Check with the store about its return policy. You may be able to return the prosthesis if the one you buy feels uncomfortable. However, this is not possible with all stores.
  • Check whether or not your private health insurance fund covers prostheses and mastectomy bras.
  • Don’t buy too many new bras if you plan on getting a reconstruction later, as you may need to get different bras to suit the reconstructed breast.
"It's like buying anything valuable. You need to take your time and make sure it's right." — Mary-Anne

Wearing a breast prosthesis

It may take time to get used to having a prosthesis. You may feel nervous about wearing it, or it may feel different depending on the weather or your clothes. It is natural to have some concerns.

Weight

Full silicone breast forms are designed to be about the same weight as a natural breast.

A prosthesis that is correctly fitted and properly supported in a bra will usually not feel too heavy, even if it feels heavy in your hands. It may take a bit of time to get used to, particularly if it has been a while since the mastectomy.

Women who continually find the regular form too heavy may want to try a lightweight form. Some women prefer to wear this kind of prosthesis when playing sport.

Temperature

Some women find that the prosthesis feels too hot in warm and humid weather. This is more common for women who have larger breasts.

There are a number of options to help you reduce any discomfort you may feel – see below. 

"My breast form gets sweaty after I've been playing tennis. I have two, so after a shower I swap." — Pam
Tips for managing your temperature
  • Choose a bra that fits correctly and holds the prosthesis in the right place. This will help keep you cool.
  • Consider new models of breast forms designed with air ventilation and evaporation technology. This can improve temperature regulation, increase comfort, and ease problems such as hot flushes.
  • Wear a lightweight form in warmer weather, which may keep you cooler.
  • If you wear a regular bra, use a bra pocket or a breast form cover to help absorb perspiration. Check if your fitter supplies covers.
  • Try wearing bras made with fast-drying or sweat-wicking fabrics, such as sports bras. This may be more comfortable if you perspire a lot.
  • Wear shirts made with cool, comfortable material, such as linen, silk or synthetic breathable fabrics.
  • Wash your prosthesis well at the end of the day to stop any perspiration from degrading the form.
Clothing

You may not need to change your clothes when you start wearing a prosthesis, but you might find you need to make some adjustments. For example, you may no longer feel comfortable wearing low-cut tops. If you have some favourite dresses or tops, bring them with you to your fitting to check how they look over different prostheses.

Your fitter may also carry a range of extras designed specifically to be worn with a breast prosthesis. These include lingerie, nightwear, swimwear, sports bras and camisettes (material that attaches to your bra strap to make low necklines more modest).

The range of mastectomy wear is constantly expanding and many attractive options are available.

Swimwear

Mastectomy swimwear can be bought from your fitter, some department stores, direct from some manufacturers, or online. Features include a bra pocket, wide straps and higher necklines.

Australian and international brands offer a wide range of styles, patterns and colours. Popular brands include Ada, Amoena, Anita, Genevieve, Jantzen, Jets, Kay Attali, Palazzi, Sue Rice (individualised fitting), Watersun, Seabird Swimwear, and Seafolly.

New season swimwear is usually available in stores at the beginning of September and November. 

"After my double mastectomy, I wore two prostheses. I had to change a lot of my clothes as I needed to wear the wide-cut mastectomy bras, which were visible with V-necks, evening wear and singlet tops." — Viviane
How to adapt clothing or use accessories

Changing your clothing and accessories might make you feel more confident and comfortable when wearing a breast prosthesis.

Many different products are available to improve the fit and appearance of your breast prosthesis. Ask the fitter or look online for specialised products. 

  • Use scarves or jewellery for extra coverage.
  • Wear a camisole or singlet under your top, or buy a mastectomy camisole bra.
  • Alter your clothing yourself or hire a tailor.
  • Try a strapless mastectomy bra or use an attachable prosthesis.
  • Sew a pocket into your bra, nightdress or swimsuit.
  • Reduce pressure from bra straps by using small shoulder cushions (check that it’s not a poorly fitting bra).
  • Use extra hooks on the back of the bra to make it more adjustable.
  • Use self-adhesive nipples (available in different sizes and colours) to look more natural.

Caring for a breast prosthesis

Prostheses are usually guaranteed for two years for general wear and tear, but they may last longer depending on how often they are worn, how well they’re looked after and your lifestyle. If the form splits or cracks at the seams, it should be replaced.

  • Handwash the prosthesis every day you wear it to remove perspiration. Use warm water and a mild unscented soap or a cleanser supplied by the breast form manufacturer. Rinse thoroughly and pat dry with a towel.
  • Rinse your form in clean water after swimming to remove any chlorine or salt.
  • Don’t wear a silicone prosthesis in a sauna or spa, as it may heat up against your skin. Use a soft, fibre-filled form instead.
  • If your prosthesis is damaged or old, it can be thrown away in your normal rubbish collection. The material cannot be recycled.
  • Store your prosthesis in the box it came in, which will protect it from sunlight and heat and help keep its shape.
  • Be careful when placing brooches or pins onto your clothing.
  • Take care when handling pets so that their claws don’t damage the prosthesis.
  • Avoid using perfumed deodorant, as this can damage the breast form. Natural crystal deodorant is a better alternative.
  • Check that your bras are the right fit every 12 months. You will probably need a new bra and breast prosthesis if your weight changes. Otherwise your prosthesis should last for 2–3 years. 

Costs and financial assistance

Cost may influence the type of breast prosthesis and bras you buy:

  • The cost of a silicone breast form ranges from about $250–$450.
  • A silicone swim form is about $130.
  • A foam form is about $70.
  • Mastectomy bras cost about $60–$100 each.
  • Bra pockets that you can sew into a regular bra cost $10–$15.
Medicare's External Breast Prostheses Reimbursement Program

Medicare provides reimbursement for the cost of a new or replacement breast prosthesis. This is available for women who are permanent residents of Australia, are eligible for Medicare, and have had a full or partial mastectomy as a result of breast cancer.

At the time of publication, the reimbursement covers up to $400 for each new or replacement breast prosthesis since July 2008. If you’ve had a bilateral mastectomy, you are eligible for a reimbursement for two breast prostheses of up to $400 each. However, as policies change, you should check what assistance is available before you buy prostheses or bras.

To make a claim for a replacement prosthesis:

  • There must be a period of two years or more between the purchase dates of the prostheses. (However, you may find that your breast prosthesis lasts longer than that.)
  • Only external breast forms can be claimed. Bras and surgically implanted (internal) prostheses aren’t covered.

Claim forms are available from any Medicare office or can be downloaded. Attach the original receipt to the claim form and hand it in at any Medicare Service Centre or post it to the address listed on the form. The payment will be made by cheque or electronic funds transfer into your bank account.

Private health insurance

Private health funds vary in their rebates for breast prostheses and related products such as mastectomy bras. Some rebates only apply to members with extras cover.

Most health funds have waiting periods and other terms and conditions. They may also require a letter from your surgeon stating why you need a prosthesis. Ask your health fund what is covered and what information is needed. You may be able to claim a reimbursement from Medicare even if you’ve received a private health refund.

You can only claim the Medicare reimbursement if the full price of the prosthesis wasn’t covered, and this reimbursement will be adjusted according to the $400 limit. For example, if you buy a prosthesis for $500, and get a $200 refund from your private health fund, your Medicare reimbursement would be $200.

Air travel with a prosthesis

You may be concerned about travelling with your breast prosthesis. It’s safe to wear or carry a prosthesis during air travel – the change in altitude and air pressure doesn’t affect the prosthesis. International security checkpoints usually require passengers to go through full body scanners, which will detect the prosthesis.

Airport security staff may organise another imaging scan or a pat-down to confirm that the prosthesis isn’t a threat. However, you should not be asked to lift your clothing or remove the prosthesis, and the screening officer should never touch it. 

Tips
  • Let the security officer know that you wear a prosthesis, if you feel comfortable. You may provide a note from your doctor or a travel communication card.
  • Request that you and/or your bag are screened in a private area.
  • Ask to be screened by a female security officer.
  • Bring your prosthesis or mastectomy bra in your carry-on bag if you don’t want to wear it. The silicone isn’t subject to any rules about liquids, gels and aerosols.
  • If you don’t think you have been treated with respect or dignity, discuss this with staff at the screening point. You can also ask to speak with a supervisor or complain in writing to airport management.
  • Contact the Department of Infrastructure and Regional Development if you aren’t happy about the result of a complaint in Australia. Call (02) 6274 7111.

Question checklist

You may find the following questions useful if you want to get more information about breast prostheses. You can talk to your breast care nurse, a breast prosthesis fitter, the Cancer Council, a volunteer from Cancer Council Connect or members of a breast cancer support group.

  • Do I need to wear a breast prosthesis?
  • What kind of prosthesis would suit me best?
  • When can I start wearing a breast form?
  • How will wearing or not wearing a prosthesis affect me if I have lymphoedema?
  • What can I do if I find the breast form too heavy or I have other problems?
  • How long might it take to get used to the prosthesis?
  • Do I need to buy mastectomy bras or can I use regular ones?
Questions for the fitter
  • How long will the fitting take?
  • Can I bring a support person to the fitting?
  • If I don’t want to remove my own bra, is it possible to be measured for a prosthesis and/or mastectomy bra without doing so?
  • Do you have a wide range of styles and colours?
  • Can you order other styles if the ones in stock aren’t suitable?
  • How do I care for the prosthesis?
  • What can I do if the prosthesis I bought is not suitable?
  • What is the warranty period for the prosthesis?
  • Can I have a second copy of the receipt for my records?
  • What is the price range of the prostheses you sell?

Key points

  • There are many types of breast prostheses to suit women’s different needs.
  • Wearing a prosthesis may help you remain balanced and may reduce back, neck or shoulder pain. It may help to boost self-esteem after a mastectomy.
  • After surgery, you can wear a soft form made of fabric or foam. Once your wound is healed, you can buy a weighted, silicone form that is more like a real breast.
  • Partial breast forms are also available for women who wish to fill out their bra.
  • Breast forms are available from specialist lingerie retailers, major department stores and mobile fitting services.
  • It is best if you make an appointment for a fitting.
  • The type of bra you wear makes a difference. It needs to fit well and be supportive. You can use your own bras and sew in a pocket, or you can buy mastectomy bras.
  • Accessories and clothing such as swimwear and nightwear are also available to make wearing a breast prosthesis more comfortable and to give you more confidence.
  • Medicare has a program that reimburses part of the cost of a prosthesis. Private health insurance funds may also subsidise breast forms and mastectomy bras.
  • Air travel with a prosthesis is safe. Security screening will detect the prosthesis, but you can ask to be screened privately by a female security officer. Prostheses are exempt from rules about liquids, gels and aerosols.

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