Breast prostheses

Thursday 1 June, 2017

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On this page: First weeks after surgery | Material used in prostheses | Types of prostheses | Buying a breast prosthesis | Wearing a breast prosthesis | Caring for a breast prosthesis | Travelling with a prosthesis | Costs and financial assistance | Question checklist | Key points  


This section provides practical information about breast prostheses for women who have had breast surgery.

First weeks after surgery

After surgery, the breast area will be tender, but you can choose to wear a light breast prosthesis called a soft form immediately.

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 wear a pocketed crop top or camisole. Because it is light and made from a smooth material such as polyester, the soft form can also be worn during the weeks you're having 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, every woman is different so check with your surgeon or breast care nurse about how long you need to wait.

My Care Kit

Breast Cancer Network Australia (BCNA) provides a free bra and temporary soft form for women who have recently had breast cancer surgery. The bra is designed to be worn immediately after surgery. It has seams that avoid pressure on scars, and extra hooks and eyes to adjust the bra for any swelling. To order a My Care Kit, speak to your breast care nurse.

What to consider – breast prosthesis

Benefits

Drawbacks

  • Can give you a more natural shape under clothes.
  • Doesn't require further surgery, which has risks and a longer recovery time.
  • Can be worn with different clothes, including during sports such as swimming.
  • Medicare subsidises the cost.
  • Can be replaced if it wears out or is damaged.
  • Can be worn while you're waiting for reconstructive surgery or during chemotherapy or radiotherapy treatment.
  • Can be matched to your breast size to correct weight imbalance.
  • Easy to change size (e.g. if the size of your other breast changes).
  • You may not like the idea of having an artificial breast.
  • You may need to wear a special bra to keep the prosthesis in place.
  • Requires special washing and storage instructions.
  • You may need to make changes to your clothes or use accessories to accommodate the prosthesis.
  • May be uncomfortable at times (e.g. heavy, hot or irritating), especially when playing sport.
  • If you aren't comfortable wearing a prosthesis, you may feel self-conscious or embarrassed, or concerned it will move or fall out.
  • Needs to be replaced every few years.

Material used in prostheses

Temporary forms tend to be made with foam, fibre-fill or fleece; these are usually worn in the first couple of weeks or months after surgery. Some women continue wearing a soft form at night-time. Another option is to use the temporary soft form with a cotton cover called a knitted knocker, which often includes the shape of a nipple. To request a prosthesis, visit knittedknockersaustralia.com.

Most breast prostheses for long-term use are made from medical grade silicone gel. The silicone is moulded into the natural shape of a woman's breast or part of a breast. The front surface feels soft and smooth. The back surface that rests against the body varies depending on whether the prosthesis is designed to go into a bra pocket or attach directly to your skin. It can be firm and smooth, flat or hollow, have ridges that are soft and flexible, have 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 attaches to the form.

What is silicone?

Silicone is a non-toxic, synthetically-made substance that is heat-resistant and rubbery. It can be moulded into the shape of a natural breast. If a prosthesis tears or punctures, the silicone can't be absorbed by the skin.

Types of prostheses

As every woman's body is different prostheses are available in a variety of shapes (triangles, circles or teardrops), cup sizes (shallow, average or full) and skin colours.

There are also partial breast forms (triangles, ovals, curves and shells) for women who have had breast-conserving surgery and want to regain breast symmetry.

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.

Symmetrical prostheses are even on both sides and can be worn on either the left or right side of the body. Asymmetric forms are designed specifically for the right or 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.

"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

Different breast prostheses and their features

Prosthesis type

Soft breast form

Three-layer breast form Partial breast form Lightweight breast form Attachable or contact breast form
Swim breast form
What the form looks like

Breast prosthesis

Breast prosthesis

Breast prosthesis

Breast prosthesis

Breast prosthesis

Breast prosthesis

When used Immediately after surgery; leisure time or sleeping Everyday use After breast-conserving surgery or if breast changes shape after radiotherapy Everyday use Everyday use  Swimming
How used Worn in a pocketed bra Worn in a pocketed bra Can be worn in the bra cup Worn in a pocketed bra Attachable; adheres to the chest wall
Worn in pocket of swimsuit
Material Polyester front cover and cotton back cover Three layers of silicone to help form drape and move more realistically depending on the type of breast it is matching – for example a younger breast, an older breast or a smaller breast
Two layers of silicone
Ultra lightweight silicone; slightly firmer lightweight silicone in the back layer helps keep the form in place when worn in a bra pocket
Standard silicone layer with super soft film
Clear, water-resistant silicone
Weight Lightweight Regular weighted silicone Regular weighted silicone
40% less than a standard silicone form of the same shape and size Lightweight Lightweight
Special features Breathable cotton back layer with temperature-regulating technology May include temperature- regulating technology Extra soft silicone, covered with a
thin film to cling gently to the breast with temperature-regulating technology
Back layer includes temperature-regulating material to reduce perspiration
Designed with a lower- cut inside edge to accommodate surgery that conserves a small area of cleavage
Dries quickly
Other considerations Not a suitable substitute for a weighted silicone breast that provides body with balance Symmetrical shape – can be worn on either the left or right side Available in a variety of shapes and sizes to replace the missing breast tissue and to achieve symmetry
Designed to drape like a natural breast so that it moves with the body and flattens when a woman lies down Follows body movements naturally; ideal for wearing with figure-hugging clothes Rinse after use to avoid chlorine or saltwater damage

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 pocketed bra if necessary.

For some women, having a fitting for a prosthesis 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. Professional fitters regularly see women who have been in a similar situation and will take a sensitive approach.

You can visit a store or you may feel more comfortable organising a home fitting. See where to buy a breast prosthesis below. It's advisable to make an appointment. This allows you to have uninterrupted time with the fitter. 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 find it beneficial to talk to a woman who is using a breast prosthesis. See information about volunteer peer support.

"It's like buying anything valuable. You need to take your time and make sure it's right." – Mary-Anne

Where to buy a breast prosthesis

You can buy a breast prosthesis from a number of retail outlets, including specialist stores that sell only breast forms and related products, the lingerie section of some major department stores and lingerie boutiques. There may also be a free home service available in your area. See information about costs.

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 worthwhile. This might also appeal if you don't want to shop where people know you.

You can also browse 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 see a fitter to be measured in person, particularly if you are buying a breast prosthesis for the first time.

Ask the store about its returns policy. You may be able to exchange the breast form for a different style or size if the one you buy feels uncomfortable. However, this is not always possible, particularly for attachable breast forms.

Call Cancer Council 13 11 20 for a list of stores where you can purchase breast prostheses, adhesive nipples, mastectomy lingerie and accessories. You can also use Breast Cancer Network Australia's local service directory to find a specialist prosthesis fitter in your area.

At the fitting

A fitting usually takes 40–60 minutes. You will have privacy when being measured and getting changed. See a list of questions you might like to ask your breast care nurse or a breast prosthesis fitter. Most fitters carry out the fitting in a similar way:

  • The female fitter will probably check 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 pocketed bras to choose from.
  • When you've chosen your bra, the fitter will help you try on several breast forms in different shapes, sizes and weights 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 also put your own clothes on, but many women find the T-shirt easier.
  • The fitter shows you how to check the breast form sits properly in the pocketed bra, and will discuss how to take care of it.

Choosing a bra

Wearing a well-fitting bra will ensure your breast prosthesis is comfortable and fits well. While some women find that their ordinary bra, sports bra or sports crop top adequately supports their prosthesis, pocketed bras are specially designed for this purpose. Features of a pocketed bra include:

Straps

Elasticised, adjustable, comfortable straps. Wide straps can help distribute the weight of the breasts on the shoulders.

Cups

Full cups with firm, elasticised edges.

Pockets

Hold breast form securely in place and protect it from damage.

Band

Thick sides that don't cut into the skin and help minimise slipping or movement of the prosthesis. Should sit close to your chest wall between the cups and have a high front at the centre.

Getting the right fit

The key to a well-fitting breast form is getting it to match your natural breast in shape and size as closely as possible. With a correctly fitting bra, it is unlikely that a form will be noticeable to others or fall out.

You can bring your own bras (regular, post-surgical or pocketed) to the fitting or your fitter can suggest a bra from their stock. Getting the right fit will help give you a natural shape under clothes. Many women say this makes them feel whole again.

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. The fitter will also check that the breast form fits correctly. A good fit will not obstruct the flow of lymph fluid in your body nor cause swelling in the arm (lymphoedema).

Most women find they get used to wearing the breast form, although this may take some time. If the breast form continues to feel uncomfortable or looks obvious, the fit is probably not right. Ask the fitter if you can be refitted.

The questions checklist may help you decide if the fit is right.

"The external appearance of my breast form is great. People often say that you'd never know I was wearing a breast form." – Ruth

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. Common concerns include:

Weight

Silicone prostheses are available in different weights to accommodate a variety of needs. A standard silicone breast form is designed to be about the same weight as a natural breast. Lightweight breast forms are about 20–40% lighter than the standard form.

A prosthesis that is correctly fitted and properly supported in a bra can make you feel balanced and 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 the weight, particularly if it has been a while since the mastectomy. Some women prefer to wear a lightweight form when playing sport or a soft form to bed.

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. New models of breast forms are designed with air ventilation and evaporation technology to improve temperature regulation and increase comfort.

"My breast form gets sweaty after I've been playing tennis. I have two, so after a shower I swap." – Pam

How to control the temperature

  • Wear a correctly-fitting bra to hold the prosthesis in the right place and help keep you cool.
  • Wear a lightweight form in warmer weather, which may keep you cooler.
  • Wear clothing made with cool, comfortable material, such as linen, silk or syntheticbreathable fabrics.
  • Use a bra pocket or a breast form cover with a regular bra to help absorb perspiration. Check whether your fitter supplies covers.
  • Wear a bra made with fast-drying or sweat-wicking fabric, such as a sports bra. This may be more comfortable if you perspire a lot.
  • Wash your prosthesis well at the end of the day to stop any perspiration from degrading the form.

Clothes and swimwear

It's common to worry about what you can wear with a prosthesis. Many women find that they don't need to change their clothes, but find they need to make some adjustments. For example, you may no longer feel comfortable wearing low-cut tops.

Your fitter may also stock a range of products designed specifically to be worn with a breast prosthesis. These include lingerie, sleepwear, swimwear, sports bras, activewear 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.

Some women prefer to swim without their breast form, but if you swim regularly, there are advantages to buying a swim form. You may also want to wear special pocketed swimwear, which includes a bra pocket, wide straps, and higher neck and arm lines. This can be bought from your fitter, some department stores, direct from some manufacturers or online.

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

How to adapt clothing or use accessories

  • Use scarves or jewellery for extra coverage.
  • Alter your clothing yourself or hire a dressmaker.
  • Try a strapless pocketed bra or use an attachable prosthesis.
  • Wear a camisole or singlet under a V-necked top, or buy a pocketed camisole bra.
  • Reduce pressure from bra straps by using small shoulder cushions (check that it's not a poorly-fitting bra).
  • Add extra hooks on the back of the bra or buy bra extenders to make it more adjustable.
  • Sew a pocket into your bra, sleepwear or swimsuit. You can find various patterns and instructions online.

Gillian's story

"When I got my prosthesis nine years ago, I thought it was best to wear it for a while and to consider other options later on.

"I wore the prosthesis for about three years before I looked into reconstruction options. I talked to people who'd had a reconstruction and considered the risk of infection, cost, recovery time and how it would look if I lost or gained weight. I decided I was happy to continue wearing a prosthesis.

"I remember my first fitting experience like it was yesterday. I still get emotional thinking about it now. The fitter's manner really helped to set me at ease. I can remember looking at myself in the mirror and thinking, 'I'm back'. The prosthesis helped me feel and look like my old self.

"I didn't take anyone to the fitting, and I hadn't told my husband I was going. When I got home he said, 'What happened to you today?" My whole demeanour had changed.

"Over the years I've worn many different types of prostheses. In that time the technology has changed and they are now cooler and lighter and look and feel a lot more natural.

"I wear my prosthesis in a pocketed bra and I forget I have it on. Wearing a properly fitting bra really helps.

"These days there's a good range of bras available – they've come a very long way. Nine years ago the bras were mostly nude and white, and now you can buy them in pretty much any colour and style, even halter-neck. I still wear the same style of clothing I previously wore.

"Wearing the prosthesis has definitely helped me with my healing and recovery after my breast cancer diagnosis."

Tell your cancer story.

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.

How to care for your breast prosthesis

  • Handwash the prosthesis after every wear. 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 the form well in clean water soon after swimming to remove any chlorine or saltwater.
  • Use a soft, fibre-filled form in a sauna or spa – a silicone prosthesis may heat up against your skin.
  • Avoid using perfumed deodorant, as this can damage the breast form. Natural crystal deodorant is a safer alternative.
  • Store your prosthesis in the box it came in, which will help keep its shape and protect it from sunlight and heat.
  • Take care when placing brooches onto your clothing.
  • Take care when handling pets so that their claws don't damage the prosthesis.
  • If your prosthesis is damaged or worn out, it can be thrown away in your general rubbish collection. Silicone cannot be recycled.
  • Check that your bra fits correctly every 12 months. You will probably need a new bra and breast prosthesis if your weight changes. Most prostheses last for 2–3 years.

Travelling 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.

How to travel with a prosthesis

  • Let the security officer know that you wear a prosthesis, if you feel comfortable. You should also carry a letter from your doctor or breast surgeon.
  • Request to be screened in a private area and by a female security officer.
  • Pack your prosthesis or mastectomy bra in your carry-on bag if you don't want to wear it. The rules about liquids, gels and aerosols don't apply to silicone.
  • If you think you haven't been treated with dignity or respect, let staff know. You can also complain in writing to airport management.
  • Contact the Department of Infrastructure and Regional Development if you are unhappy about the response of airport staff to a complaint in Australia. Call 1800 075 001.
  • Visit travelsecure.infrastructure.gov.au for more information.

Costs and financial assistance

The cost of a breast form and bra vary depending on the type, which may influence your choice. Some women may choose not to replace the prosthesis regularly because of the cost.

Following is a guide to the average cost of forms and bras:

  • silicone breast form – $250–$450
  • silicone swim form – about $150
  • foam form – about $70
  • mastectomy bra – $40–$100
  • bra pockets that you can sew into a regular bra – $10–$15.

Medicare's External Breast Prostheses Reimbursement Program

The cost of a new or replacement breast prosthesis can be claimed through Medicare. 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, can make a claim for a new prosthesis every two years.

At the time of publication, Medicare's External Breast Prostheses Reimbursement Program 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.

As policies change, check what assistance is available before you buy prostheses or bras. Visit humanservices.gov.au and search for "breast prostheses".

How to make a claim for a replacement prosthesis:

  • Allow two years or more between the purchase dates of the prostheses. In some circumstances, you may be able to make additional claims but you will need to provide a letter from your doctor or surgeon.
  • Obtain a claim form from any Medicare office or download from humanservices.gov.au (search for "breast prostheses form").
  • Attach the original receipt to the claim form and return by email, post or in person at a Medicare Service Centre. The payment will be made by electronic funds transfer into your bank account.

Private health insurance

Rebates for breast prostheses and related products such as mastectomy bras vary between private health funds. 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.

Women with private health insurance may also be able to claim a reimbursement from Medicare. If the full price of the prosthesis wasn't covered by your private health insurer, you can claim through Medicare, but 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.

Question checklist

You may find the following questions useful when considering wearing a breast prosthesis.

You can talk to your breast care nurse, a breast prosthesis fitter, Cancer Council 13 11 20, a volunteer from Cancer Council Connect or members of a breast cancer support group.

Questions to ask the breast care nurse or fitter

  • Do I need to wear a breast prosthesis?
  • What kind of prosthesis would work best for me?
  • Is there something suitable after breast-conserving surgery?
  • 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 pocketed bras or can I wear regular ones?

Questions to ask 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 match my skin tone?
  • Do I feel balanced?
  • Does the surface of the bra look smooth?
  • 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.)
  • Do I like how I look with the prosthesis in place?

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 bra, is it possible to be measured for a prosthesis and/or pocketed 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?
  • Is there a prosthesis that keeps me cool?
  • If the prosthesis feels heavy, can I get a lighter breast form?
  • What is the price range of the prostheses and bras you sell?
  • Can I wear a prosthesis without wearing a pocketed bra?
  • How do I care for the prosthesis?
  • What can I do if the prosthesis I bought is not suitable?
  • What happens if I puncture my prosthesis?
  • What is the warranty period for the prosthesis?
  • How long will my prosthesis last?
  • What should I do if my breast size changes before I'm due
  • for a replacement?
  • Can I have a second copy of the receipt for my records?

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 selfesteem after a mastectomy.
  • After surgery, you can wear a soft form made of fabric or foam. Once the wound is healed, you can buy a weighted, silicone form that feels and moves more like a natural breast.
  • Partial breast forms are also available for women who wish to fill out their bra.
  • Breast forms are available from specialist lingerie retailers, some major department stores and mobile fitting services.
  • It is advisable to make an appointment for a fitting, and to take someone for support.
  • 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 pocketed bras.
  • Accessories and clothing such as swimwear and sleepwear are also available to make wearing a breast prosthesis more comfortable and to give you more confidence.
  • 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.
  • Medicare can reimburse part of the cost of a prosthesis. Private health insurance funds may also subsidise breast forms and pocketed bras.

Reviewed by: A/Prof Elisabeth Elder, Specialist Breast Surgeon, Westmead Breast Cancer Institute and Clinical Associate Professor, University of Sydney, NSW; Jo Cockwill, Consumer; Suzanne Elliott, Consumer; Bronwyn Flanagan, Breast Care Nurse, Brightways, Cabrini Hospital, VIC; Maina Gordon, Consumer; Gillian Horton, Owner and Corsetry Specialist, Colleen’s Post-Mastectomy Connection, ACT; Kerry Nash, Sales and Marketing Manager, Amoena Australia, NSW; A/Prof Kerry Sherman, Macquarie University and Westmead Breast Cancer Institute, NSW. We are grateful to Amoena Australia Pty Ltd for supplying the breast form images. The breast reconstruction images have been reproduced with permission from Breast Cancer: Taking Control, breastcancertakingcontrol.com © Boycare Publishing 2010.
Updated: 01 Jun, 2017