External Breast Prostheses Options After Breast Cancer

When you decide on a mastectomy or lumpectomy for the treatment of breast cancer, you may wonder what your options are in the post-surgery period. Some people have immediate breast reconstruction while others opt for delayed reconstruction. Yet others decide against reconstruction altogether and choose an external chest prosthesis as the best choice for themselves personally.

The best choice for reconstruction or no reconstruction, as well as the type of breast prosthesis you would like if you don't have reconstruction, is very personal and depends on your own preferences alone. There isn't a right or wrong answer, but only what is right for you. 

If you choose to forego reconstruction and use a breast prosthesis (also called a breast form) it is possible to achieve a symmetrical appearance. Yet where do you begin? There are so many possible options!

From size to skin tone, let's take a look at what you might desire in a breast prosthesis.

Breast Prostheses for Regaining Your Symmetry

Low angle view of mature woman walking in breeze
How can you find an external breast prosthesis that is right for you?. Cultura RM Exclusive/Natalie Faye/Getty Images

After breast cancer surgery with or without reconstruction, you don't have to use a breast prosthesis. Many women, however, find that selective a prosthesis is one way in which they can take control of their appearance. Breast cancer can be challenging from a body image standpoint (especially if you will also be bald from chemotherapy) and finding a substitute bosom is one way you can pamper yourself.

With the proper fit, nobody will know you're wearing an external prosthesis. The story of a breast prosthesis coming loose at church can bring a touch of humor to a room full of breast cancer survivors but is actually uncommon.

A good breast prosthesis can help in several ways. A breast form can:

  • Balance and normalize your appearance: Certainly, the greatest benefit of a prosthesis is maintaining your "usual" appearance at a time when many changes are occurring.
  • Protect your surgical scar: A soft breast prosthesis can provide a cushion as your incisions heal. This can be especially helpful if you have family and friends who are "huggers."
  • Prevent your bra from moving around: A well-fitted prosthesis can hold your bra in place so that it fits securely and won't irritate your tender post-surgery skin.
  • Balance weight on your shoulders: Many women are surprised by how a mastectomy or even lumpectomy can change their center of gravity. 

Best Advice on How to Choose and Buy a Prosthesis

There are many different places where you can purchase a prosthesis, from specialty stores near your cancer center to a plethora of online options.

If you can do so, going for a professional fitting in a brick and mortar store is ideal. Many of these stores have fitters who have worked with hundreds of women after breast cancer surgery and have experience guiding people to the best products for their particular needs.

Go for a professional fitting, and wear a snug-fitting blouse when you do. Breast prostheses aren't sized like bras, so you can't count on getting a form that fits by referencing your bra size. A professional prosthesis fitter can help you find a model that's the right shape and size, as well as one that is a proper weight and match for your lifestyle.

Colors, Shapes and Features of Breast Forms

Breast forms are available in different sizes and shapes.

  • Some are symmetrical, so they can be used on either side, and some are designed to be asymmetrical (used only on your right or left side).
  • Some forms have "nipples" and others are completely smooth.
  • You can choose either weighted or lightweight forms.
  • There are forms available for active sports, including forms for swimming.
  • All breast prostheses come in various skin tones, so you are sure to find a color that suits you.

Silicone Breast Prostheses

A silicone breast prosthesis comes the closest to imitating breast tissue in weight and drape. A good prosthesis will also have some movement similar to your real breast.

Although the weight of this kind of prosthesis can prevent shoulder muscle aches, it can also feel heavy or leave you feeling hot if you're outdoors a lot or participating in sports. Silicone prostheses can be custom-made so that you can be perfectly symmetrical, though they are the most expensive options.

Fortunately, a 2017 study found that the weight of external breast prosthesis does not appear to significantly impact trunk biomechanics during normal movements, so you can rest assured that your spine isn't being overworked by the load of a silicone prosthesis.

Non-Silicone Breast Prostheses

A non-silicone breast prosthesis may be made of foam rubber, fiberfill or cotton. These are lighter in weight than silicone prostheses and can be worn as soon as you'd like after a mastectomy. If you are physically active, this kind of prosthesis may be for you. A non-silicone breast prosthesis doesn't have the weight and drape of a real breast, but it is cooler to wear and less expensive than silicone.

Partial Breast Prosthesis

If you feel unbalanced after a quandrantectomy (segmental mastectomy) or lumpectomy, you can use a small, partial breast prosthesis or "equalizer" to help fill out your bra on your surgery side. These are made of silicone, foam rubber, or fiberfill. A partial breast prosthesis can be tucked into your regular bra, or into the pocket of a mastectomy bra.

Attachable (Contact) Breast Prosthesis

If you don't want to wear a mastectomy bra you might want to consider an attachable prosthesis. Also called a contact prosthesis, these have adhesive strips or Velcro tabs, which allow you to attach your prosthesis directly onto your body. This kind of prosthesis will move with you, and it can be worn with a regular bra. Contact prostheses come in full-breast sizes and partial breast shapes.

Adhesive Nipples

Not everybody has nipple reconstruction after a mastectomy, so there are adhesive nipples that you can use to complete your reconstructed breast if you choose. Latex nipples, which are held in place with fluid adhesive, are easy to remove and reusable. Silicone nipples come in different colors and don't require any "glue" to keep them in position. Either kind of nipple can be custom-made to match your own.

Keep in mind that you don't need to have nipple reconstruction or use artificial nipples. Some women find that not having nipples frees them from having to cover up their nipples beneath clothes.

Knit a Breast

Leave it to the British to come up with knitted breasts to help teach new mothers about breastfeeding. Several talented knitters have created knitted "breasts" that are gaily colored, very soft and cozy, and use either a knot or a button in place of a nipple. You can see some of these creations, designed by breast cancer survivors, at Ravelry.com and Knitty.com, where you can also find a pattern. Homemade breast forms are good options if you're on a tight budget. The pattern for the Knitted Boob in the photo can be found at the artist's website, courtesy of Marte.

Knotted Nylons

Those of us who have no knitting skills can still consider making our own breast forms. Nylon, knee-high stockings come in various skin tones and can accommodate many fillings, such as small rounded seeds, grains or plastic bean bag pellets. Since nylons stretch, you can fill them until you create the desired size. Secure the form with a knot and a few stitches (the closure doubles as the nipple on your homemade breast form.) Keep in mind that these won't feel very realistic and may not be waterproof.

Balloons and More

Remember playing with water-filled balloons? Kids still throw them at each other during hot weather. Water balloons, water or gelatin-filled condoms, and balloons filled with silicon caulking material have also been used to create breast forms. These kinds of breast prostheses may not last very long, as they can puncture and leak rather easily. But, they may be the least expensive option you can create.

Post-Surgical Camisole

There are special camisoles that have pockets to hold your prosthesis and drainage bulbs. These are great options for while you are recovering from breast surgery. These offer comfort, security (no dangling drain bulbs) and modesty. A pocket camisole will help you feel attractive as well as comfortable as you heal.

Mastectomy Bras

Mastectomy bras accommodate breast forms and breasts. They have pockets for prostheses and come in nice styles and colors. These are the same size as regular bras. If you're having trouble fastening the hooks, you can get a front-closing style. Some have wide straps and comfortable sides to prevent rubbing as you heal.

The Tender Loving Care post-mastectomy camisole bra is one of the prettier options; it has a lace inset (Manufacturer's Website).
If you contact a volunteer from the American Cancer Society's Reach to Recovery program, you may be given a "starter" mastectomy bra and a temporary breast form. Their volunteers are breast cancer survivors who are trained to give you support and information.

Product Manufacturer Websites

Here's a short list, approved by the American Cancer Society, of some websites that supply breast forms, nipples, bras, camisoles, swimwear, and more.

Bottom Line 

While an external breast prosthesis isn't necessary, studies suggest that they have a positive effect on women both physically and psychologically after a mastectomy from breast cancer. There are many options available with a wide price range. Every woman is different, and only you will know that best option for you personally.

Sources:

Hojan, K., and F. Manikowska. Can the Weight of an External Breast Prosthesis Influence Trunk Biomechanics during Functional Movement in Postmastectomy Women. Biomedical Research International. 2017. 2017:9867694.

Jetha, Z., Gul, R., and S. Lalani. Women Experiences of Using External Breast Prosthesis After Mastectomy. Asia-Pacific Journal of Oncology Nursing. 2017. 4(3):250-258.