Breast Prosthesis

A breast prosthesis is an artificial breast form that replaces the shape of all or part of the breast that has been removed. It fits in a bra cup with or without a bra pocket. Most breast prostheses are made from soft silicone gel encased in a thin film. They’re molded to resemble the natural shape of a woman’s breast or part of a breast. The outer surface feels soft and smooth and may include a nipple outline. Lots of women who have had surgery for breast cancer and have not had reconstruction wear a breast prosthesis. However, it may also be useful for women whose breasts are naturally different from each other in size or shape, or who have had breast reconstruction that has not given an even match. For some women, wearing a prosthesis may be a temporary choice prior to reconstruction. Other women may choose not (or be unable) to have breast reconstruction and find wearing a prosthesis an effective and suitable long-term choice.

Risks and complications

• Bleeding: Bleeding is a risk of lots of operation, but the need for transfusion is very unlikely. However, specialized surgeons are well concerned and will always keep control to stop bleeding during surgery.
• Infection: Infections are very rare complications.
• Nipple necrosis: The blood supply of the nipple might be damaged with the more limited surgery, and the nipple could die. If the nipples are used as grafts, then it is possible that they might not survive. These complications are exceedingly rare.
• Scarring: The scars of the areola usually heal very well. The scars below the breast will take longer to fade out and will widen as mentioned above; however, a raised or excessively wide scar is possible and might need further treatment. It is possible that there may be residual tissue left, which appears as a contour deformity. This would need to be removed at a second stage.

How should I look after my breast prosthesis?

The prosthesis fitter will give you information on how to care for your particular type of prosthesis. If you follow the advice on looking after your prosthesis it should last several years. Generally, you should look after a silicone breast prosthesis as you would your own skin. Wash it daily in warm soapy water and dry it with a towel. If you have a stick-on prosthesis there may be specific products that you need to use to keep the prosthesis clean. Your prosthesis supplier will be able to tell you more about these.

When you aren’t using your prosthesis, store it in the shaped unit inside the box it came in. Take care not to catch the prosthesis with sharp objects such as rings or brooches as these may damage it, causing the silicone to leak. If it does get damaged, you can usually seal the tear temporarily with sticking plaster.

Do I need to have a prosthesis or a reconstruction?

Deciding whether or not to wear a prosthesis or get a reconstruction after surgery is a personal decision. Reactions to the loss of a breast or breasts vary from woman to woman. Only you can choose what feels right. You do not need to make a decision immediately. Unless you are considering having reconstruction at the same time as the mastectomy, there is no time limit on when you must decide. Take the time you need to consider your options. There may be a number of reasons why women who have had a mastectomy choose to use a breast prosthesis or to have a reconstruction. However, some women decide not to use a prosthesis or have a reconstruction. For example, if you had breast-conserving surgery, you may feel that your breast shape didn’t change much.

Some reasons women choose to wear a breast prosthesis or have a reconstruction include:

Creating symmetry when wearing clothing

Most women don’t have identical breasts – the muscle and tissue on each side of the body are different. However, after a mastectomy, these differences are usually more noticeable. A prosthesis or reconstruction may help you feel and look more symmetrical.

Restoring self-esteem

You may find that recreating a more natural appearance with a prosthesis or reconstruction helps to boost your confidence.

Replacing the weight of the lost breast

When a breast is removed, the body is no longer balanced. This can cause a slight curving of the spine and a drop of the shoulder on the affected side. These changes may lead to lower back and neck pain over time. Issues with balance after having a mastectomy can affect women of any breast size. A prosthesis or reconstruction can help with balance.

Adjusting to the diagnosis and treatment

Using a prosthesis or having a reconstruction may help some women cope better with the experience of cancer. You might feel like you are taking control of your appearance

Breast Prosthesis FAQ’s

How long does the operation take?

Although some surgeons aim for operations taking minutes, a good quality BA takes up to one hour.

Can it be done under local anaesthetic?

Technically, yes, but for reasons of comfort a brief general anaesthetic is preferred.

Can it be done as a day-case?

Yes, it is very common to have BA as a day-case, but it is wise to not travel too far from the hospital on the first night in the rare event of a complication.

Will I have wound drains?

No, it is neither necessary nor preferred with respect to encapsulation rates to have drains for a primary BA. It is, however, usual to have drains – usually for only 24 hours – when secondary or revision surgery has been performed.

Will it hurt?

This depends on many factors, including the individual’s pain threshold and the technique employed, but today’s best procedures usually give little or no pain, with the vast majority of women being able to return to their activities of daily living the very next day.

Is it more painful under the muscle?

Again, if done properly, there is no reason why it should be more painful, although there are some who have intertwined muscles that may be more sore for a day or so afterwards.

What is the recovery time?

One should be back to normal activities within a day or two, but driving should be left for a week and aerobic exercise or the gym 4-6 weeks. You should be back at work after a week, but this may be influenced by exactly what job you do.

Are there any complications?

As it is a surgical procedure, there is the potential for unwanted consequences such as bleeding and infection, which are rare. Your surgeon should discuss these in detail with you before surgery.