Using a Breast Prosthesis After Surgery.

A prosthesis worn with a single mastectomy is most common and is fairly easily managed, although it may be difficult to keep the prosthesis in place during vigorous exercise. For women with a bilateral mastectomy, it is more difficult to keep a bra in place, so wearing a prosthesis can be problematic.

A prosthesis is an external, artificial breast form that provides the contour of a breast and is available with or without a nipple. It is secured in a bra, normally by slipping it into an inner pocket in the cup, or it is attached to the skin with special adhesive.

Prostheses come in many shapes, sizes, materials and colors. A small filler or shell is used when a lumpectomy with a wide excision has left the breast noticeably asymmetrical. A prosthesis also may be used after reconstruction if your body weight has changed and you need to match your breast size.

There are stores that specialize in breast prostheses. They usually have professionals who can help you find a prosthesis that fits well. Prostheses also are available by catalog. Another option is custom-made prostheses. They are more expensive than the ready-made version, but may provide a better match to the remaining breast.

There are no significant side effects to wearing a prosthesis. Select a bra that is supportive and has a compartment to hold the prosthesis so that your skin is not chafed throughout daily wear. A prosthesis tends to be heavier than a breast, and it may take time to get used to it. Adhesive prostheses may cause a rash where the adhesive comes in contact with your skin.

Most hospitals will have someone to talk to you about your prosthesis options before you go home. A nurse or social worker specializing in breast cancer also may have examples of prostheses so you can learn about the different types that are available. Often you can get a temporary prosthesis from your hospital or a volunteer group such as Reach for Recovery. A prosthesis may be used at any point following a mastectomy once the surgical site has healed and your doctor says it is safe to start wearing one.

If you are buying a ready-made prosthesis, a sales assistant will help you select the right bra to wear with the particular prosthesis you try. The process is much like shopping for a well-fitted bra, with the addition of looking for a prosthesis that will help you achieve a symmetrical look. You usually will have the choice of purchasing a prosthesis with or without a nipple.

Expect to pay from 100 to 500 dollars for your prosthesis, depending upon size, construction and whether it is ready made or custom made. Many stores offering prostheses also offer the custom-made type or they can refer you to another company that provides custom services. Health insurance will normally cover most of the cost of a ready-made prosthesis. Medicare or Medicaid should provide at least partial reimbursement. If you opt for a custom-made prosthesis or are not sure about insurance coverage, consult your insurance company.

A correctly sized prosthesis should last for several years with proper care. Most prostheses only require washing in warm, soapy water, and storage in the original case or mold when not being worn at night or for extended periods of time.

If you enjoy swimming or water aerobics in a chlorinated pool, it is a good idea to purchase a chlorine-resistant prosthesis specifically for that use. Chlorine will shorten the life of your everyday prosthesis by gradually eroding the surface material. A chlorine-resistant prosthesis is generally less expensive because it is not made to look and feel as real as your everyday prosthesis.

Going without a prosthesis

Breast replacement is not a medical necessity. The choice of whether or not to pursue breast replacement is entirely that of the breast cancer survivor. She may want the input of her partner or friends, but ultimately it is her needs that should determine her decision.

Some women who have had a mastectomy decide not to wear a prosthesis and not to have reconstruction. They feel comfortable with their body as it is. These women may feel this way from the beginning or over time. There is no right choice for everyone. The most important thing is that you do whatever is most comfortable for you.

There are no side effects to not wearing a prosthesis or not having reconstruction. It is important to remember that if you initially choose not to pursue reconstruction, you can change your mind later. Time elapsed since cancer surgery is not a factor in being able to have reconstruction.