A breast prosthesis is an artificial breast form that fits inside a bra cup to replace your natural breast. It is most often used after surgery for breast cancer - either a mastectomy (removal of your breast) or a wide local excision (removal of a lump and some surrounding tissue). A well-fitting prosthesis can help your posture and give you a more natural shape.
Firstly you will be fitted with a temporary breast prosthesis, which is a lightweight fibre-filled shape. You will probably be advised to use this for the first 6 to 8 weeks after your surgery because your body needs time to heal as it may be tender and sore.
Permanent breast prostheses are made from silicone gel, moulded to form a natural breast and nipple shape. The surface feels soft and smooth. The underside of a prosthesis is not always the same. On some prostheses, the underside can be smooth and on others it can have ridges that are soft and flexible.
Are there different types of prostheses?
Prostheses come in a wide variety of different shapes, sizes and skin colours. They are made from materials that will move, feel and weigh like a normal breast. A breast prosthesis can help improve your balance and posture after breast surgery. You should be able to find a prosthesis to suit your particular needs. The most common type of prosthesis rests against your chest wall and is held in place by your bra, but there are a number of different types to choose from.
If you have had a wide local excision or lumpectomy you might not have lost much breast tissue, but the amount lost might be enough to make your breast a different shape. This will depend on the size of your breast and where the lump was and it will affect the type of prosthesis that you need.
You might need a ‘shell’ type prosthesis that is hollow and fits over your remaining breast tissue to make your breast look like its original shape. Or you might need a small, wedge-shaped prosthesis that will fill out the bottom, top or side of your bra.
Graphic of a partial prosthesis
Most prostheses are made to weigh roughly the same as your normal breast, but some women find that these still feel too heavy. You might prefer to wear a lightweight prosthesis. These are also made of silicone but they weigh less than standard prostheses.
Graphic of a lightweight prosthesis
Self-supporting (stick-on) prostheses
Self-supporting prostheses stick directly to your skin with adhesive strips on the back. This type of prosthesis suits some women better, particularly if they are very active.
Some women find that these prostheses feel more natural and secure than the other types that simply fit into a bra cup. However, if you choose this type of prosthesis you still need to wear a bra that fits well and that gives you and your prosthesis good support. You will need to wait at least 6 months after your surgery before using this type of prosthesis.
Prosthetic nipples are artificial nipples. They come in different sizes and skin colours. You can stick these onto your breast prosthesis or directly onto your skin after you have had breast reconstruction if you do not have a nipple.
Hints and tips - Getting the right prosthesis
Picking the right prosthesis can be a step in the right direction towards feeling more comfortable with your body after breast cancer surgery. Here are some tips for your prosthesis fitting:
Pick a qualified fitter with a good range of prostheses and bras so you can try on different ones and have a choice.
You may feel self-conscious at your fitting but remember that the fitter is experienced and is there to help you. Bring a friend for support and advice, if it helps you feel more comfortable.
It can take some time to get used to your prosthesis and it may feel heavy at the start but call the fitter if you have any questions or worries after you get home.
Can I wear a prosthesis straight after surgery?
A temporary prosthesis is lightweight and fibre-filled and can be worn immediately after surgery. Your breast care nurse will give you one while you are in hospital.
This temporary, fabric prosthesis will give you a shape similar to your natural breast while you are recovering after your operation.
Whatever type of breast surgery you have had, you will not be able to wear anything that puts pressure on your scar and the surrounding area for 6 to 8 weeks. When your scar has fully healed you might need to have further treatment such as radiotherapy, which can make your skin tender and sensitive for a while.
You may find it more comfortable to wear your temporary prosthesis until this sensitivity has gone completely. You might decide to carry on using your temporary prosthesis for leisurewear or at night.
Some women find that a bra is uncomfortable during this time. If you prefer, you can wear a camisole top or a vest. Choose a top or vest that is made with Lycra to give you support.
Who does the fitting?
The breast care nurse or a trained mastectomy fitter can fit both your bra and your prosthesis. Most lingerie shops and department stores have trained fitters. An appointment may be made for you before you leave the hospital. If not, your breast care nurse will provide you with contact details for qualified fitters in your area. To find your local prostheses supplier please call our Cancer Nurseline Freephone 1800 200 700 and speak to one of our cancer nurses.
How do I choose a prosthesis?
You might find it helpful to look at some breast prostheses before you go for your fitting or even before your operation. Your breast care nurse can show you some samples of different prostheses.
To find your local prostheses supplier please call our Cancer Nurseline Freephone 1800 200 700 and speak to one of our cancer nurses.
How do I choose a bra?
You will need a bra that fits you well to ensure that your prosthesis is comfortable. Even if you think you know your bra size, it is still best to see a trained bra fitter.
You will need to choose a bra that fits close to your chest wall between the cups, with enough depth of material between the cups to cover the prosthesis. Usually you can get a good result with a well‑fitting, full-cupped bra. Half-cupped, push‑up or balconette bras are not suitable to wear with breast prostheses.
Some women feel more secure with a mastectomy bra. Mastectomy bras have a pocket in the cup to hold the prosthesis. You can also adapt an ordinary full-cupped bra by sewing in a pocket.
How should I prepare for the fitting?
It is a good idea to take a plain, light-coloured, close-fitting top or t-shirt with you for your fitting. This will help you to check that the prosthesis you choose gives you a smooth outline. You might also want to take a favourite bra or a dress that you would still like to wear. If you want, you can take a friend or partner along to give you support and to offer their opinion.
To find your local prostheses supplier please call our Cancer Nurseline Freephone 1800 200 700 and speak to one of our cancer nurses.
How will my new breast prosthesis feel?
At first, a breast prosthesis might feel cold but will warm up quickly when in contact with your body. It might also seem heavy, but the sense of weight will be less noticeable once it is held against your chest wall and supported by your bra. It can take some time to get used to your new prosthesis but if you have any questions call the fitter.
Do I have to pay for my prosthesis?
All women who have had breast cancer surgery are entitled to their first prosthesis and two bras free of charge. Ask your breast care nurse about arranging your first fitting.
Hints and tips - Looking after your prosthesis
Here are some tips to help you to look after your prosthesis:
It is important that you look after your prosthesis carefully and follow the care instructions that come with it.
Most prostheses should be washed every day with warm soapy water and patted dry with a towel.
Always keep your prosthesis in its box when you are not wearing it so that it does not get damaged.
Prostheses are generally guaranteed for 2 years, as long as the care instructions have been followed, but often last longer.
How do I get a replacement prosthesis?
Prostheses are generally guaranteed for 2 years, as long as the care instructions have been followed, but often last longer. Your prosthesis will need to be replaced when it shows signs of wear or damage, or when you gain or lose a lot of weight.
Medical card holders
If you have a medical card, you are entitled to two bras every year and one breast prosthesis every two years (2 prostheses if you have had bilateral surgery). To avail of this, you need to get a prescription for these items from your GP. This prescription needs to go to your local health office for approval. Some fitters will take care of the paperwork on your behalf.
If you need help to find your local fitter ask your breast care nurse, call the Irish Cancer Society Cancer Nurseline on Freephone 1800 200 700 or visit a Daffodil Centre. You can call the fitter to see if they can do the paperwork for you. If you are going directly through your local health office yourself, you may have to complete a form and let them know which fitting centre you wish to attend.
After the health office has processed your application, which can take a few weeks or longer, you will be sent an official order form called a purchase order which you need to bring to your fitting appointment. If you have your fitting before your approval issues then your fitter can put your items aside for you and have them posted to you when it issues.
At your fitting you should have a choice of different bras and prostheses to choose from and your fitter will help advise on the best fit for you. If you choose a more expensive item than is funded by the medical card allocation, you may have to pay the shortfall, but you should be offered at least one option that is covered by your medical card allocation.
In all instances, it is always best to telephone your local fitting centre in advance to check:
Can they help you with the paperwork?
Will you need to make any payment for your items?
Do you need to book an appointment?
Most fitters work by appointment only.
Private patients can buy replacement prostheses from retail shops or mail order suppliers. Some insurance policies will reimburse you for your prostheses, bras and swimwear every year but you will need to check your insurance policy to find out what is covered and how you must submit claims.
All necessary medical purchases can be claimed against tax. Details on tax relief for medical expenses and other related claims are available from:
- Lo-Call 1890 33 34 25 (Dublin Region)
- Lo-Call 1890 44 44 25 (East & South East Region)
- Lo-Call 1890 77 74 25 (Border Midlands West Region)
- Lo-Call 1890 22 24 25 (South West Region)
Monday to Thursday from 9.15 am - 5.30 pm & Friday from 9.15 am - 5.15 pm.
Visit www.revenue.ie for more information.
How can I cope with breast surgery?
Most women who are treated for breast cancer have some type of surgery. Whatever your age or personal circumstances, it is normal to have concerns about how you will cope with losing a breast. Whether you lose part of your breast or all of it, any change to your body image can be a traumatic event.
Many women who have been through this experience describe it as being like the death of a close friend or family member. If you have a partner or children you might be worried about their reactions to your surgery and to you wearing a prosthesis. You might even think that it is going to change the way they feel about you.
Recovering emotionally from breast surgery can take some time. Each person is different so try not to worry too much if you feel you are not coping as well as someone else you know who has also had breast surgery. If you are finding it difficult or feeling alone remember that there are people who can help you. Tell your family and friends how you feel so they can support you. You can also talk to your breast care nurse.
You might find it easier to share your feelings with someone who has had a similar experience to you. Survivors Supporting Survivors is a programme that helps and supports women who have recently been diagnosed with breast cancer.
If you have been diagnosed with breast cancer, the Irish Cancer Society Cancer Nurseline can put you in contact with a Survivors Supporting Survivors volunteer who has already had surgery for breast cancer. All the volunteers have been carefully selected and fully trained. These volunteers can provide you with advice and reassurance when you need it most.
For more information on Survivors Supporting Survivors or support groups in your area, visit a Daffodil Centre or call the Irish Cancer Society Cancer Nurseline on Freephone 1800 200 700.
Standards of care
The Irish Cancer Society has produced standards of care for breast prosthesis and bra fitting services. The Society created these standards of care after national research that looked into how breast prostheses are provided, fitted, supplied and used in Ireland.
During this research, women with breast cancer were asked about their experiences with breast prostheses, as well as about breast care nurses, prosthesis and bra fitters.
These standards of care will help you know what to expect when you go to a prosthesis and bra fitting service. They are also useful guidelines for people who provide the service.
Standards of care for breast prosthesis fitting services:
A fitting service should encourage women to make contact with the service and put her at ease. Everything possible should be done to ensure the best possible fitting experience.
The fitter should be trained, knowledgeable and sensitive to women’s needs. A woman should have a choice of seeing a female fitter.
The fitting environment should be easily accessible and spacious with good lighting and ventilation. A range of products should be on display and the room should have fitting rooms for privacy and a full-length mirror.
Women are entitled to a prompt appointment. Adequate time should be made available for the fitting and for women to receive appropriate emotional support.
Women are entitled to see and try a range of products so that they can choose the best product to meet their individual needs.
Women should always be measured for a breast prosthesis and/or mastectomy bra. If it is appropriate for a woman to be measured without removing her bra, this option should be offered to her.
Chosen products should be made available to women in a timely fashion. If there is a delay, women are entitled to know the reason for the delay and how long they have to wait.
Women should be carefully informed about how to care for their prosthesis according to the manufacturer’s instructions.
Women should receive impartial information about alternative products and ranges available from other sources. Brochures from a variety of ranges should be made available to all women.
An information leaflet outlining what to expect at the prosthesis fitting should be made available to all women, as well as clear guidelines on entitlements and the replacement of prostheses and mastectomy bras.