Types of breast prosthesis

A breast prosthesis is an artificial breast form that can help to restore shape when all or part of the breast has been removed. It fits in a bra cup, with or without a bra pocket.

Prostheses is the word for more than 1 prosthesis.

Prostheses come in lots of different shapes, sizes and skin tones. Most are made from materials that are designed to look and feel as similar to a natural breast as possible.

A temporary or soft-form prosthesis is a lightweight breast form that you wear for the first few weeks after surgery.

Your breast care nurse will usually give you a temporary prosthesis but if they don’t, you can ask for one while you’re in hospital.

You might hear these prostheses called softies, comfies or cumfies. They’re designed to be gentle against healing wounds while giving you the shape of a breast inside a bra.

They’re fabric-covered prostheses that contain a removable filling, like cotton wool. You can remove some of the stuffing so that it better matches your remaining breast, if you’ve had a single mastectomy. Some hospitals may offer foam prostheses or prostheses filled with lightweight plastic beads instead.

You can attach the temporary prosthesis to the bottom of your bra cup with safety pins or sew it in place. But it’s important to keep safety pins away from your skin and surgical wound while you’re healing.

You can be fitted with a permanent prosthesis once your wounds have healed, usually within 6 to 8 weeks.

Some people choose to wear their temporary prosthesis long-term instead of a permanent prosthesis.

Full or standard permanent prosthesis

A full prosthesis is usually made of silicone and designed to be worn in a bra after a mastectomy. It’s matched in size, shape and skin tone to your other breast.

If you’ve had both breasts removed, you can choose the size you feel most comfortable with.

Full prostheses come in different shapes.

Symmetrical

A symmetrical prosthesis is usually an oval or triangle shape. You can wear it on either the left or right side.

Teardrop

The teardrop shape might work better if your breasts are fuller at the bottom and sides and less full above the nipple. You can also wear it on either the right or left side.

Asymmetrical

An asymmetrical prosthesis is designed for the left or right side and has an extension to fit under the arm or upper chest. It’s generally more suitable if you’ve had a larger amount of breast tissue removed.

Partial or shaped permanent prosthesis

You might wear a partial or shaped prosthesis (also called a shaper or enhancer) if you’ve had breast-conserving surgery. You wear it inside a bra to fill out any differences in volume, size or symmetry and give a smooth breast outline.

Partial prostheses are usually made of silicone and come in different shapes such as ovals, ellipses or triangles. You can place one at the top, base or side of the breast, depending on where you want to fill in your breast shape.

Shell prosthesis

This is a type of partial prosthesis that you may use if your breasts are different sizes.

It’s a soft shell of silicone that fits over your smaller breast so that it matches the larger one.

This type of prosthesis can also be useful if:

• Your breasts are not symmetrical after breast reconstruction surgery

• You have an expander implant, which is gradually expanded over time to match the size of the remaining breast

• You’re having delayed breast reconstruction or waiting for surgery to make your breasts more symmetrical

• The shape of your reconstructed breast changes with time

Stick-on prosthesis

A stick-on or adhesive prosthesis sticks directly to your skin. It can be full or partial and has a sticky surface on the back.

This might suit you if you’re more physically active or want to wear a less supportive bra, as not all the weight is taken by the bra. An adhesive prosthesis sticks more easily to an even surface, so may not work for you if your chest wall is uneven after surgery.

You can wear a stick-on prosthesis with strapless dresses and tops if the clothing is supportive enough. And if you want to wear it as a regular prosthesis in a bra or bra pocket, you can put a protective backing over the sticky part.

You’ll usually be advised not to wear a stick-on prosthesis for 6 to 12 months after surgery or radiotherapy, as it may damage the skin.

Custom-made prosthesis

Custom-made prostheses usually use a 3D scanner to produce a computerised image of the chest area, which can then be used to create a customised prosthesis shape. It’s made to give a good fit to the chest, which stops the prosthesis moving, and is matched to your skin tone.

Custom-made breast prostheses are generally not available on the NHS.

Air-inflated prosthesis

An air-inflated prosthesis comes with a pump so it can be inflated to the required size. They're not widely used and may not be available in all hospitals.

Leisure prosthesis

Leisure prostheses are made especially for exercise, including swimming. They often have a channel at the back to let water drain away and stop sweat from building up.

Although you can swim in a silicone or foam leisure prosthesis, it’s important to rinse it well afterwards to avoid possible damage from the chlorine or salt water.

Leisure prostheses are usually lightweight and some are clear. These prostheses are not always available on the NHS and you may need to pay for them.

Materials

Most prostheses are made from silicone, which is a soft gel-like substance. They’re moulded to look like the natural shape of a breast or part of a breast and may include a nipple outline.

They can also be made from foam, which is lighter and cooler than silicone. This may be more suitable if you’re particularly active. You may also find this style more comfortable in warmer weather.

Some prostheses are filled with lightweight plastic beads. These mould into the shape of the bra and can be cooler as they let air circulate.

There are also breast forms that do not try to closely resemble a natural breast, if you want an alternative to a traditional soft silicone prosthesis. These come in different colours and designs. They may not be available everywhere on the NHS. Speak to your treatment team if you're interested in trying a non-traditional prosthesis.

Non-silicone prostheses may not be available on the NHS. Talk to your prosthesis fitter about other breast form options if you feel silicone is not right for you.

Weight and size

Silicone prostheses come in different weights and sizes.

The best weight for you will depend on the weight of your other breast. If you’ve had both breasts removed, you can choose the weight you feel most comfortable with.

If you’ve had a single mastectomy, a full-weight prosthesis may make you feel more balanced as it matches the weight of your other breast. It may also reduce any uneven strain on the neck, shoulders and spine.

However, sometimes a lighter version might be more comfortable.

When you’re fitted for a prosthesis, the fitter will aim to match the size and volume of your other breast. They will also aim to match the fullness of your natural breast with a prosthesis shape that’s similar.

If a breast prosthesis is too light, it may move around or ride up so it’s not level with the other breast. If this happens, discuss it with your prosthesis fitter. You may need to be refitted or get advice about wearing a different type of bra.

Unlike bra cup sizes, which use the letters A to L, prosthesis sizes use numbers from 0 to 18. Your fitter can tell you more about this.

Skin tones

Many prostheses are available in different skin tones.

It may be difficult to get an exact match to your skin tone. But having a prosthesis that’s as close as possible may help you feel more comfortable and confident.

Some companies make prostheses to order or can add colour to existing products to match your skin tone. These specially made prostheses may take longer to supply and may not be available in all hospitals.

You can also make or buy a cover for your prosthesis that’s a closer match to your skin tone (see below).

Talk to your breast care nurse or fitter about finding a prosthesis that works with your skin tone.

Backings and covers

The backing of most prostheses is made of the same material as the front.

Some prostheses may have a different backing, such as fabric or a soft panel of gel, designed to make them more comfortable.

There are also backings that can be moulded to fit an uneven chest wall.

Some prostheses have backings that allow more airflow and may be cooler.

You can also use a soft fabric cover to fit over the silicone surface, although this may mean the prosthesis does not sit as well in your bra. This can help stop sweat collecting behind the prosthesis, which could cause a rash or skin reaction.

You could also use a bra pocket to prevent this.

If you get a skin rash under the prosthesis, talk to your breast care nurse or GP.

Prosthetic or artificial nipples are made of soft silicone and can be worn on a reconstructed breast or prosthesis. They either have a sticky back or come with special skin glue that can hold the prosthetic nipple in place for several days.

Prosthetic nipples come in different sizes and skin colours. Some hospitals custom-make them so they match the nipple on your other breast.

Some specialist companies that make prostheses also produce prosthetic nipples.

If you’ve had a single mastectomy, you may prefer to use a nipple shield or cover on the other nipple so there’s less of a difference. You can buy these from some high street pharmacies or department stores and online.