Shopping for a Permanent Prosthesis

Ask your doctor when it's appropriate for you to shop for a permanent breast form. You can probably begin shopping as soon as you're feeling strong and the swelling and tenderness are gone from the incision. If you are planning to have breast reconstruction, you may want a prosthesis before it's time for your surgery.

Breast forms are available in many shapes and sizes. Some prostheses feel like plastic bags, some are rubbery, some feel very much like skin. They may be covered with a soft fabric, polyurethane, or a silicone envelope, and they may be filled with foam rubber, water, air, chemical gel, polyethylene materials, polyurethane foam, silicone gel, or ceramic particles. Like natural breasts, prostheses vary in weight, and their consistency varies from very soft and pliable to relatively firm. Some brands have models specifically for the right or left side; some are made with a modified nipple and can be worn with or without a bra. Custom-made forms, which adhere to the chest wall and closely match the remaining breast, are also available.

Small prostheses, sometimes called equalizers, are available for women who have had lumpectomies or segmental mastectomies. Women whose reconstructive surgery does not replace the nipple or whose breast form does not have a nipple may choose a nipple prosthesis. Extremely lightweight forms are available to wear in a nightgown or with leisure clothes.

When selecting your prosthesis you'll also need to find a properly fitting bra that will hold the breast form in place. You may be able to wear the same bra you have always worn if it fits well and does not have underwires. Special postmastectomy bras are available-they are built up to cover a larger area of the chest and have wider straps and pockets inside the cup to hold the prosthesis. You can sew a pocket into your swimsuit and your standard bras to keep the breast form in place.

Breast prostheses are sold in surgical supply stores, in lingerie and corset shops, and in the underwear departments of large department stores. Many stores that sell breast forms also carry lingerie and sportswear specially designed for women who have had mastectomies. Look in the Yellow Pages under "Brassieres" or "Surgical Appliances." Reach to Recovery volunteers can often provide information on types of permanent prostheses and a list of where they are available locally.

Before you go out to try various breast forms, you should call ahead and see if the supplier has a professional fitter to meet with you. More than a dozen different breast forms are on the market, and the only way to find the best one for you is to try them on. Your breast form should feel comfortable, have a natural contour and consistency, and remain in place when you move. It may feel heavy at first, but you will get used to the extra weight. Ask the fitter if the form absorbs perspiration or other chemicals from the skin and how to clean and care for your prosthesis. Most prostheses are guaranteed for 1 to 5 years.

Prices for breast forms range from $7 to $265. Custom-made forms are more expensive. The expense is covered, at least partly, by most medical insurance policies. A written prescription from your doctor will help ensure payment. If your insurance does not cover a prosthesis, you may be able to deduct the cost as a medical expense on your income tax.

If you want some emotional support when you shop, ask your partner or a good friend to go with you. Wear a form-fitting blouse or sweater so you can see how the form will make you look.

The most important thing to do is shop around. It's worth your time to find a prosthesis that feels comfortable and keeps you looking your best.