Breast Prostheses, Bras, and Post-Mastectomy Products
Prosthesis categories
Prostheses vary by weight (lightweight foam or fiberfill versus weighted silicone), shape (triangular, oval, teardrop, symmetrical versus asymmetrical), profile (shallow to full projection), backing (soft versus firm), and attachment (pocketed in a bra versus adhesive). Partial prostheses (shapers, shells) restore contour after lumpectomy or during reconstruction. Custom prostheses serve unusual contours or significant asymmetry.
Bra selection
A mastectomy bra has pockets to hold the prosthesis, wide cushioned straps, a band that stays level, and no underwire where tissue is fragile. Fit the band first, then the cup; the prosthesis should fill the pocket without gaping or riding up. Cotton or moisture-wicking linings help skin health.
Matching and symmetry
Match the contralateral breast in size, shape, and projection, not just volume. Consider nipple position, upper-pole fullness, and how the prosthesis behaves when the patient moves, bends, or reaches. Weight balance matters: a heavy prosthesis on one side can cause shoulder and neck strain.
Traps to expect
- Selecting by cup size alone without checking projection and shape.
- Placing a weighted prosthesis in a bra without a pocket.
- Ignoring the contralateral breast's natural ptosis when matching.
- Forgetting that swimwear and activewear need dedicated pocketed designs.
Worked rule of thumb
Trial at least two shapes and profiles in the same bra. Ask the patient to sit, stand, reach overhead, and bend forward. If the prosthesis shifts, gaps, or the band rides up, change the bra before changing the prosthesis.