Non-Surgical Options for Breast Reconstruction
Many women choose not to have breast reconstruction because:
- they feel comfortable living with only one breast.
- they don't want to have more surgery;
- their partners or families do not think reconstruction is necessary;
- there is no plastic surgeon who does breast reconstruction in their area.
If you choose not to have breast reconstruction, you can:
- Live without a breast replacement, or
- Get a prosthesis (false breast).
Some women who choose not to have reconstruction may wear a prosthesis or stuff their bras with padding. Others choose to do nothing. The side of the chest with the mastectomy simply remains flat, and the mastectomy side of the bra remains empty.
Advantages of No Replacement:
Wearing no replacement may be:
- more convenient
- more comfortable
Disadvantages of No Replacement:
- Some women may feel unbalanced with only one breast.
- It may be harder to keep your posture straight because of the imbalance.
- It may be harder to wear some kinds of clothes with only one breast.
A prosthesis is a breast form you can use under clothing to recreate the breast. Some women choose to use a prosthesis until they have breast reconstruction, while others use prostheses for life.
Where Do I Get a Prosthesis?
Prostheses can be purchased at surgical supply stores, pharmacies, custom lingerie clothing shops, or a private home service.* Contact the Reach to Recovery program of the American Cancer Society for information about which stores in your area sell prostheses (telephone 1-800-ACS-2345). You may want to contact the stores first to ask if they offer a trained fitter. Fitters know how to take your measurements so that the prosthesis fits your chest and matches your other breast. They can also show you how to wear it. When you have the prosthesis fitted, consider trying on samples under a variety of your own clothes.
*If you live in the Ann Arbor, Michigan area, you may want to try Personal Touch. They have a great selection of prostheses and post-mastectomy wear, a trained nurse fitter, and a web site with lots of good information on prostheses, local breast cancer support groups, and caring for yourself after breast cancer.
How Does the Prosthesis Stay in Place?
Special bras, lingerie and bathing suits are designed for breast cancer survivors. They are available from Nordstrom, Sears, Land's End, JC Penney, or American Cancer Society catalogs, as well as department stores and smaller specialty shops. The clothing comes with a pocket to hold the prosthesis, or you can have pockets sewn into the suits or bras you already own. This helps keep the prosthesis from popping out during swimming or other physical activities. One product comes with adhesive Velcro patches to attach the prosthesis to the upper part of your chest. This allows you to go bra-less or wear a regular bra. Many active women and athletes choose this model. (Since some women are allergic, ask the store to let you take home and try a sample of the adhesive before buying the whole product.) The adhesive lasts from three to five days and the prosthesis can even be worn while swimming or in the shower.
How Do I Choose a Prosthesis?
There are many shapes, sizes and materials of prostheses. The ideal product has the shape, weight, motion, and balance of your natural opposite breast. You'll probably want to get more than one type of prosthesis. Before you go into surgery, consider contacting your local Reach to Recovery program of the American Cancer Society (1-800-ACS-2345). They provide a free temporary prosthesis to all women who are undergoing mastectomy. You can adjust the temporary prosthesis by filling a cloth cover with as much fiberfill as you need to match the other side.
While this temporary model is helpful for the initial recovery period, you will probably want to buy a longer-lasting prosthesis at some point. There are two main types. A lightweight style (made of polyfill or foam) is also good for the initial post-surgery recovery period. It can be used later for warm weather activities or times when you want less weight. This type is machine washable.
The second type is made of silicone. Most women prefer this style, because it is more lifelike. Two shapes are available: asymmetrical (one for the left side, one for the right) and symmetrical, a pear shape worn sideways to fill out the side, or straight up for fullness and cleavage. Silicone is closer to the consistency and weight of a natural breast. You may find the weight a bit tiring, but it can help balance the other breast and keep your posture straight. Silicone products are hand washable. Many prostheses are shaped to include a nipple on the front.
Prostheses also come with different kinds of covers. Most have some type of cloth cover, like soft cotton. Others come with a latex cover. Some brands now offer a cloth pad on the back to absorb perspiration and keep you cooler. Ready-made products come in many sizes; you choose the one that matches your natural side. It's worth taking the time to find one that matches your other breast and is comfortable. If you really want to splurge, you can buy a custom-made prosthesis that is made specially for you, to fit the contour of your body and match your other breast.
How Much Will It Cost?
Prices of silicone prostheses range from $200 to $500. Foam and fiberfill prostheses usually cost less than $100. Cost depends mostly on quality and brand. A custom-made prosthesis will cost much more. If you want your health insurance to reimburse you, be sure to get a prescription from your doctor for the prosthesis. Prostheses last from two to five years. (Swimming pool water, salt water, and hot tubs will damage silicone prostheses.) Most insurance coverage pays for two bras with a prosthesis pocket per year and a new prosthesis every two years. If you do not have insurance, check with the American Cancer Society. Many offices give away free prostheses that stores have donated.
Advantages of Prostheses:
- Prostheses may give you a more natural shape under clothes.
- Prostheses may give a more "balanced" look.
- Prostheses do not require surgery.
- If your natural breast size changes, you can buy a new prosthesis.
Disadvantages of Prostheses:
- You may be less comfortable in revealing clothes than if you had reconstructive surgery.
- A prosthesis may be heavy, feel hot, and move around inside the bra.
- You may need to wear a special bra so the prosthesis doesn't fall out (or buy a model with adhesive).
- It may be less convenient to do certain things, such as playing active sports, than if you had reconstruction or did not replace the breast.
- It ís tough to scratch an itch underneath a prosthesis.
- Prostheses do not change size with weight gain (although you can buy a new prosthesis to match the change in your natural breast).