Reconstruction
techniques after a mastectomy have improved greatly in recent years, with much
more natural results.
Even so, about 37
percent of women choose not to have reconstruction, according to a study
published in February, 2014 in the Journal of Clinical Oncology.
Some women simply
choose to live without a breast, or even the appearance of a breast. However,
many others turn to breast forms — also known as prosthetic breasts or external
breast prostheses.
These breast forms can
make it easier to wear clothes more attractively and, some women say, feel more
like your old self.
They're not perfect —
and they won't feel exactly like a breast, of course.
Here's what to know if
you're considering this option.
Every woman has a
personal reason, or many, for deciding to forego breast reconstruction, says Elizabeth Chabner Thompson, MD, MPH, a radiation oncologist in
New York, Everyday Health columnist, and entrepreneur who has launched a
company producing post-surgery bras and other products.
"Age is a huge
factor," she says. Sometimes older women will simply decide not to, that
it's not important to them. If a patient has a serious heart condition or other
medical issues, she may decide she doesn't want to undergo another surgery
after the mastectomy, unwilling to face the risk every surgery carries, Dr.
Thompson explains.
Thompson's mother,
Davi-Ellen Chabner, a teacher and writer from Boston, had a mastectomy in 1993.
For her, the main focus was the mastectomy surgery. "I was very focused on
getting rid of the breast cancer," says Chabner, now 70.
After much thought,
she says, ''what I came away with was, 'I really didn't want anything else.''
She has been using breast forms ever since. She's remained very
active, finishing 10 marathons in addition to her professional accomplishments,
but is the first to acknowledge that the prostheses aren't perfect — and can be
a bother. She's sometimes removed the form before crossing that finish line
because it was sliding around and distracting her.
Among the types of
breast forms or prostheses for use after a mastectomy are:
- Silicone forms, worn
externally.
- Nonsilicone forms, made of foam
or fiberfill, designed to be worn right after a mastectomy or during
workouts or hot weather.
- Attachable breast forms,
designed to be fastened to the chest wall by using adhesive strips.
- Soft camisoles with breast
forms for wearing right after a mastectomy, while healing is in progress.
The form is placed into a pocket in the camisole.
After a mastectomy,
you become asymmetrical, says Kathleen Gill Bazazi, a fitter of breast forms at Massachusetts General Hospital.
The breast form can help you regain some symmetry, she says, and in the process
help your posture — perhaps along with your self-image.
"If you have one
breast, you aren't even, and you are going to favor one side," she says.
As a result, ''you limit your clothing choices and your lifestyle."
Many women tell her
having the breast form there helps them feel more comfortable with what they are wearing.
She finds having the
right form can help women stand up straighter, with less spinal curvature and
perhaps less muscular pain from slouching.
The forms come in many
different materials, styles, and sizes, with nipples or not. Experts suggest
you go to a mastectomy boutique or specialty shop that has on staff certified
fitters as well as the breast prostheses, along with post-mastectomy bras, swimsuits, and camisoles. Ask your
surgeon for a good referral.
Wear a top that is
form-fitting, such as knit, so you will be able to see exactly how the forms
will look under clothing.
It's crucial to have
an individual fitting, Bazazi says. When trying on forms, she says, focus on
fit, comfort, and style — and whether both sides match.
"Unless you have
had extreme surgery, 90 percent or more of women can achieve symmetry [with the
breast forms]," she says.
Right after the
mastectomy, she recommends women get a soft foam form, with no weights, to
allow the body to heal.
Four to six weeks or
so later, she says, women can begin to look at the weighted silicone and other
forms. ''The silicone breast prostheses are weighted to match the breast on the
other side," she says.
Be patient while
shopping, say Bazazi and Thompson. It takes time to find the best prosthesis
for you. "It's like finding a favorite bra that you like," Thompson
says.
Don’t be pushed into
buying one brand or a form you aren’t sure fits well, Thompson advises.
You may also want a mastectomy bra or you may want pockets sewn into clothes
so the form can be slipped in.
In general, Medicare
and some insurance plans cover the cost of the bra and form, provided you have
a prescription from your doctor. However, plans typically limit the coverage,
paying only for a certain number of forms and bras within a specified time.
Check before you shop.
Before buying, ask
about the form's life expectancy. Be sure you know how to wash it and how
often.
A final tip, from one
who knows: "If it doesn’t feel right, take it back," says
Chabner.
Everyday Health
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