Breast prostheses are breast forms intended to simulate breasts. There are a number of materials and designs; although, the most common construction is gel in a plastic film meant to simulate skin. Prostheses may be purchased at a surgical supply store, pharmacy, custom lingerie shop, or even through private services that come to a person's home. Customized options are also available from specialty shops, which moulded to fit an individual's chest by taking an impression of the breast. The areola and nipple may be replicated as part of the breast form or as separate nipple prosthesis. Both custom made and off-the shelf breast prostheses come in varieties that are designed to either be held in a pocket in a specially designed mastectomy bra or attached to the skin via adhesive or other methods and worn with a standard bra. Breast prostheses have a long history. In the 19th century they were made of rubber. On 22 September 1885, one Charles L. Morehouse received US patent 326915 for his "Breast-Pad", made of natural rubber and filled with air at normal pressure.
Uses
External breast prostheses are commonly used in women who have undergone surgical treatment for breast cancer such as a mastectomy or lumpectomy. They have a variety of physical benefits including improved symmetry and balance, as well as psychological benefits such as improved self-confidence. Outside of post-surgical uses, prosthetics are also used by individuals to create the illusion of breasts.
Mastectomy
Breast prostheses are most commonly used after a mastectomy, usually a consequence of cancer. They are often molded to mimic the natural shape of a woman's breast and can either be used temporarily or for long-term use as an alternative to, or prior to surgical breast reconstruction. Depending on the type of mastectomy performed, progress of post-operative healing, and other various factors, surgeons will determine the time when a patient can start to use a prosthesis. A prescription may be required for breast prostheses and mastectomy bras for insurance purposes.
Post-Mastectomy Bras
Post-mastectomy bras are similar to regular bras with the exception of containing spandex stretch pockets on the inside that help keep the breast prosthesis in place. Post-mastectomy bras can be found at specialty shops or mastectomy boutiques and some shops are also willing to stitch pockets into regular bras, swimsuits, etc. to hold prostheses.
Attachable Breast Prostheses
Attachable breast prostheses can be used as an alternative to post-mastectomy bras. Attachable breast prostheses can be attached directly to the skin via adhesives and can also be worn with a regular bra.
Lumpectomy
After a lumpectomy or a quadrantectomy individuals may be left with an asymmetrical sillhouette. Breast prostheses can help to act as an equalizer to accommodate for the missing tissue. Examples of breast prostheses after small but not total breast tissue removal include partial breast prosthesis, and attachable breast prostheses. Partial breast prosthesis are available in a variety of materials such as silicone, foam, or fiber. These inserts are able to discretely fit into a regular bra or into the insert of a mastectomy bra. Attachable breast prostheses anchor directly onto your body and are secured using adhesive or Velcro. Attachable prostheses can be custom made as a partial breast shape, as well as coming readily available in full sizes. These prostheses, unlike the partial prostheses, move independent of a bra and can be worn along with a regular bra. For those who do not want a bra specially designed for prostheses, an attachable option may be a consideration.
Breast Enhancement
Transgender
Many pre or non-hormonal trans women and men who cross-dress as women use breast prostheses in order to create the illusion of feminine breasts. They are sometimes combined with cleavage enhancement techniques when used with clothing with low necklines. Full frontalCleavage Tops are also available, mainly marketed to the Transgender community. They incorporate a pair of breast prostheses in a one-piece skin coloured garment that is designed to provide the illusion of natural cleavage. Such garments have the disadvantage of having a visible top edge at the neck, which requires the wearing of a choker or similar necklace to hide the top edge of the garment. The edges of the breast prostheses are often distinguishable through the thin outer cover.
Types
Styles
Full/Standard Prosthesis- This prosthesis goes directly onto the breast wall and is used in those who have had all breast tissue removed. Size, shape and skin tone can be customized to matched your other breast, or If both breasts have been removed, any size may be selected.
Partial Prosthesis- Unlike a full prosthesis, this can be used in situations where part of the breast has been removed. It is worn over the breast tissue inside the bra to create a fuller appearance and fill the breast outline.
Shell Prosthesis - When breasts differ in size from each other, this type of partial prosthesis can be used. A soft shell of made of silicon is placed around the smaller breast to help match the size of the larger one.
Stick-on Prosthesis - This prosthesis sticks onto the skin and can be either full or partial. Women who have a more active lifestyle, or who wish to place less weight on their bra, prefer this prosthesis. Another benefit is that strapless clothing can be worn with this prosthesis, as long as the clothing can provide some support.
Custom-made Prosthesis - Some shops can customize prosthetics to match natural color, size of other breast, and the bodies natural contour. Silicon and latex materials are normally used, however these customized prosthetics are more expensive than those that are not custom made.
Shapes
Non-customised prostheses are made of different shapes to suit the extent of breast tissue removal or the shape of a crossdresser's chest. Asymmetric breast forms incorporate an extension towards the armpit to replicate the shape of the tail of Spence, while symmetric "triangle" or "teardrop" prostheses do not incorporate that extension. Customised prostheses will mirror the other breast.
Other Considerations
Insurance
Breast prostheses or mastectomy bras are covered by most insurances. To get these covered one should obtain a prescription from their physician with the diagnosis and need documented on it. External breast prostheses are covered under Medicare part B following mastectomy; surgeries in the outpatient setting are also covered under Part B while part A covers mastectomy surgeries in the in patient setting. Custom-made prostheses are not usually covered by insurances due to their high costs.
