Post Mastectomy Reconstruction: Choosing a Prosthesis or Breast Form
Q. I’m having a mastectomy, and although I’ve heard about reconstruction and implants, I just feel they’re not for me. I think I’d like to wear something external. What are my options?
A. First of all, congratulations on making your decision. It’s a difficult time, trying to decide what you want to do about your altered body geography – if anything – after you’ve had a mastectomy. In the end, it’s a personal decision, and the only “should” that comes into the equation is this: Your decision should make YOU happy.
Anything external you wear – not an implant, not reconstruction – is called a prosthesis or, less formally, a breast form. Made of soft, pliable material, it fits inside a regular bra; or a special mastectomy bra, equipped with a pocket to hold the form. You can even attach some forms right to your body (they’re removable, of course!)
Forms come in all shapes and sizes, just as women’s breasts do. Most also come weighted, to mimic the weight of your other breast, so that the two will “hang” right, side by side. (If you’re particularly small-breasted, this is a feature you won’t need.)
Forms are also made from different materials, most commonly fiberfill, or silicone; most forms, these days, are waterproof silicone, so you can wear them in your bathing suit. (Speaking of bathing suits, the Lands End catalog offers a nice selection of mastectomy-friendly bathing suits.)
Q. Where can I get a form?
A. Ask your doctor, his or her nurse, or one of the hospital social workers where you can get a form. They’re often available at lingerie shops or medical supply houses. If you’re at a large enough cancer center, they may even sell them right there.
Many hospitals offer services from Reach to Recovery, an outreach group of the American Cancer Society devoted to helping breast cancer survivors deal with multiple issues, including obtaining a breast form. If you’re uninsured, Breast Cancer Network of Strength, a volunteer survivor group, will send you a form for a small fee.
You may also choose to shop for a form online, or through a catalog; the American Cancer Society’s tlc catalog is a good place to start. Although it’s tough to judge the fit and look sight unseen, this might be your best choice, if you’re uncomfortable shopping in person, or you can’t find a store close by.
Q. How do I go about getting one that fits right?
A. This is the perfect opportunity for a shopping trip with a good girlfriend. Bring something to wear that’s fairly form-fitting, like a clingy shirt; i.e., it should show your body as clearly as possible. If you like the look of your form under that kind of scrutiny, you’ll like it in anything you wear.
Depending on where you’re shopping, there may be a trained fitter there to help you out. If not, just browse the offerings, and pick a few that seem as though they’d mimic your other breast–including the nipple. (Yes, forms now come with a nipple!) Slip them into your bra one by one (mastectomy bra, if you have one), put on your shirt, and take a look. Have your girlfriend give you a fair assessment, too, from all sides.
Don’t rush; if you’ve chosen to go the breast-form route, take the time to select one that really fits well. And here’s a hint: just like with shoe shopping, not only should the form look good, it should feel comfortable. A form that’s too heavy can actually affect your shoulder adversely, especially if you’re prone to lymphedema.
If you can’t find anything you like, it’s possible to have a form custom-made; shops that offer forms may offer this service, as well. Be advised they’re quite expensive, though, and your insurance may not cover a custom form.
One distinct advantage forms have over reconstruction or implants is that they’re easily swapped out; if you get one you end up not liking, it’s simple to try another. So spend the time to make a wise choice, but don’t do TOO much mental hand-wringing as you go through the process; it’s not irreversible.
Finally, if you have a very favorite style and brand of bra, don’t think you have to give it up: depending on design, you can get a form pocket sewn into it. Check out this option at the store where you buy your form.
Q. So how much is all of this going to cost?
A. Forms go from inexpensive ($10) to WOW (many hundreds of dollars). If you have health insurance, check with your insurance company as to exactly what they’ll cover; some will only cover forms from a particular manufacturer, or a specific source.
At any rate, get your doctor to write you a prescription for one; it helps push through your request with the insurance company, and it’s a necessity if you have Medicare coverage (which will pay for a new form every year or two, so long as you get a prescription).