Frequently Asked Questionsour Certified Mastectomy Fitter is a great source of information about your post-surgery options and can provide insight and guidance on what to expect and if a particular breast form is right for you.
WHAT IS A BREAST PROSTHESIS?
An external breast prosthesis is an artificial breast form that is worn after a mastectomy. Choosing to wear a breast prosthesis is a personal decision. Many women select this option because they want to have the same symmetry when wearing clothing as they had before their surgery. A prosthesis offers other advantages as well: it protects a woman’s chest and surgical scars, helps balance posture, anchors the bra on the side of the mastectomy and keeps it from shifting side to side or riding up, and helps prevent problems with curvature of the spine, shoulder drop, and muscular pain in the neck and back. Breast prostheses are made from several different types of material (such as silicone gel, form and fiberfill) that feel similar to natural breast tissue and are usually weighted so they feel the same as the remaining breast. A prosthesis fits snugly into the pocket of a postmastectomy bra, which is fitted with pockets on the inside to hold the device in place.
Types of prosthetic devices:
External silicone breast prosthesis: This type of device is made of silicone and has excellent compatibility with the skin and body. The weight, softness, movement and resilience are close to that of the natural breast. It has a natural propensity for conducting heat, allowing the prosthesis to assume one’s own natural body temperature immediately. It is kind to the skin, well tolerated by the body, and resembles the natural breast in weight and consistency. It is an externally worn product and is completely safe. A silicone prosthesis is weighted to help prevent shoulder drop and poor balance but is not heavy enough to be uncomfortable. A lightweight, buoyant silicone form specifically for swimming is also available. This form can safely be worn in hot tubs or saunas and can easily be inserted into the pocket of a mastectomy swimsuit.
Non-silicone breast prosthesis: This prosthesis is a lightweight breast form made of foam or fiberfill and can be worn immediately following a mastectomy with no complications whatsoever. It can also be worn during exercise and in hot weather.
Post-surgical soft-form camisole: A post-surgical camisole is made of a soft, stretchy material with lace elastic straps and is often worn immediately following a mastectomy, lumpectomy, radiation therapy to the chest, or following reconstructive breast surgery. A lightweight, removable soft breast form can be placed into a pocket in the camisole.
Partial breast prosthesis: Also called an equalizer, shell, shaper or enhancer, this device is made of foam, fiberfill, or silicone. It’s designed to be worn over a woman’s own breast tissue to create a fuller appearance after a part of her breast is removed, (as in the case of a lumpectomy). Shapers are also used as an enhancer during reconstruction, to adjust for weight gain or loss after reconstruction, or to offset imbalance that results from the natural aging process.
I HAD A LUMPECTOMY OR RECONSTRUCTION, AND MY BRA NO LONGER FITS PROPERLY. IS THERE SOMETHING AVAILABLE TO HELP EVEN OUT MY FIGURE?
Shapers/Shells are the perfect solution for women who experience asymmetry after a lumpectomy or reconstruction. The shaper will even out your figure just where you need it.
WHY DO I NEED TO BE SPECIALLY FITTED FOR A BREAST FORM AND BRA?
Breast shapes, skin tones, surgery and body types vary. A Certified Mastectomy Fitter has been specially trained to help you choose a breast form that best matches your natural breast and will help restore balance and a positive body image. The fitter will also measure you for a post-surgery bra to hold your breast form in place and talk to you about the benefits of a properly fitting bra and breast form.
WILL WEARING A BREAST FORM RESTRICT MY ACTIVITIES?
Not at all. You can play tennis, golf, run or participate in any sport you’ve always enjoyed. You may want to increase your wardrobe of breast forms to include a swim form for water activities and a leisure form for times when you’re relaxing at home.
HOW DO I KNOW IF A LIGHTWEIGHT SILICONE BREAST FORM IS RIGHT FOR ME?
Many women find that a lightweight form is more comfortable. Women with medical conditions such as arthritis, lymphedema or osteoporosis may benefit from a lightweight breast form. Your fitter will help you choose the breast form that is right for your lifestyle, body type and surgery.
MY FORM FEELS HEAVY. IS IT TOO LARGE?
The first thing to evaluate is the fit of the bra. Bras have a lifespan of three to six months of constant use before they need to be replaced. If the bra doesn’t adequately support the breast form and hold it snugly against the chest wall, then the straps of the bra begin to support more weight from the form than necessary, pulling down on the shoulder area. This results in the form feeling heavy.
CAN I WEAR MY BREAST FORM WHEN I SWIM?
Yes, you can wear most breast forms in the swimming pool, ocean or hot tub, however it may weigh down your swimsuit. If you swim regularly, you may want to ask your fitter about a form made especially for swimming. Whether you wear your regular breast from or a swim form during your water activities, be sure to clean it thoroughly afterwards to remove chlorine and salt residue from the form.
WHEN SHOULD I BE FITTED FOR A PROSTHESIS?
After the scar tissue of surgery has completely healed and the swelling has subsided, fitting for a silicone prosthesis can take place. This healing process typically takes between four and eight weeks. In the interim, there are soft, comfortable leisure bras, camisoles and postmastectomy garments available which can be worn with a foam or fiberfill breast form with no complications whatsoever. Fitting is done by a certified fitter who is specially trained to fit women for a breast prosthesis in a warm and caring environment. At the first fitting appointment it is recommended that women wear a form-fitting garment such as a knit top, so they can see how the shape and size of the breast form matches their other breast. It is also important to plan adequate time — up to an hour, for discussing all the options with the fitter. Body type, breast shape and lifestyle are all areas that should be considered. Any additional questions or concerns with regards to insurance, billing, prior authorizations, and obtaining a prescription can also be addressed at this time.
HOW LONG WILL MY PROSTHESIS LAST?
Most breast prostheses are warranted against manufacturer’s defects for two years from the date of purchase. The warranty does not cover damage to the form from punctures or from erosion to the outer layer due to perfume or lotions. With proper use, care and storage, your breast form should provide years of comfortable wear, although it is still a good idea to see a Certified Mastectomy Fitter at least once a year to have your fit evaluated, as women’s bodies change with age and weight.
HOW DO I CARE FOR MY BREAST FORM?
Skin oils can break down the outer layer of a breast form and shorten its useful life. I recommend that your breast form be hand-washed with mild soap and water and patted dry daily. It should be stored in the specially-designed breast form box. It is extremely durable with normal use, although care needs to be taken with sharp objects, pets and jewelry.
WHAT IS A POST-MASTECTOMY BRA?
post-mastectomy bra is a garment that is specially designed with a pocket which securely holds the prosthesis in place. Post-mastectomy bras are soft, comfortable and pretty, and offer a relaxed support that makes them easy to wear. Choosing and wearing the right-sized bra is important. A poorly-fitted bra can cause shoulder, neck and back tension, sagging breasts, as well as uncomfortable bulges around your breasts and upper arms. A bra that fits best will depend upon style, manufacturer and fabric, so be prepared to try on several bras before you make your final selections. A trained and certified fitter may take measurements and use a formula to work out the bra size. This is helpful as a guide, but more importantly, finding the perfect supportive bra will involve trying on many different bras and having hands-on checks to make sure the shoulder straps, bra underband, and cups fit perfectly.
Things to look out for when trying on a bra:
Shoulder straps – should fit closely to the body without cutting in. They should lift the breasts so that they sit on the chest wall, midway between the shoulder and elbow, and stay in place when you raise your arms above your head.
Front and back bands – should lie close to the body and be the same level at the front and back.
Cups – should be filled by the breast without any areas of loose fabric, or any breast bulging out of the side or top, and high at the sides to cover the breast. Bras rarely last longer than a few months, especially if you wash them regularly in a washing machine. Hand washing can prolong their lifespan, and helps to keep the shape and color too. Be prepared to replace your bras each year, and always re-measure after losing or gaining weight, or following menopause. This way you can be sure your breasts will always be properly supported.
DOES INSURANCE COVER MASTECTOMY SUPPLIES?
Medicare, Medicaid and most insurance carriers will cover the cost of mastectomy supplies as long as women have a prescription from their doctor. Generally, Medicare, Medicaid and most insurance plans will pay for one silicone breast prosthesis every two years, up to two foam, leisure or swimforms every year, four mastectomy bras per year, two postmastectomy camisoles the first year after surgery, and two permaform bras every year. Most insurance companies do not cover mastectomy swimsuits. Women should check with their insurance carrier before the fitting to determine what is covered under their plan. If you are unsure about what you are entitled to, I can make the phone call for you. Pink Ribbon is contracted with most major insurance companies including Medicare and Medicaid, so most women pay very little, if any, out-of-pocket expense.
WHAT OTHER PREVENTIVE CARE IS COVERED BY MEDICARE?
Medicare covers a small, but essential, range of preventive care services regardless of whether you have met your Part B deductible. 80% of the cost of one screening mammogram a year (every 12 months) for women 40 years and older, regardless of whether they have met their Part B deductible. Medicare will also pay for one baseline mammogram for women 35 – 39 years of age. 100% of the cost of one Pap smear lab test every two years (24 months) for all women with Medicare (It covers the usual 80% of the doctor visit to collect the Pap smear). Note: If you are considered at high risk for cervical or vaginal cancer, for eg: 1. You have had a sexually transmitted disease 2. Your mother was given the drug diethyistilbestrol (DES) during pregnancy 3. You are of childbearing age and have had an abnormal Pap test in the past 36 months Medicare will cover the cost of one Pap smear a year (every 12 months). When you get your Pap smear, Medicare will also pay 80% of the cost of a pelvic exam and a clinical breast exam. 80% of the cost of one bone mass measurement every two years (24 months) after you pay your annual Part B deductible, if you are at risk for osteoporosis (eg., have a family history of the disease, have certain conditions, such as thyroid disorders, or have taken certain medications for a prolonged period of time, such as steroid anti-inflammatory). Will also cover follow-up measurements if your doctor prescribes them.
Medicare covers 80% of the following mastectomy supplies if your doctor prescribes them:
One silicone breast prosthesis every 2 years, OR One lightweight foam prosthesis every 6 months. Up to 12 mastectomy bras per year (3 per quarter). Up to 2 mastectomy camisoles within 6 months after surgery. Up to 2 performance bras per year.