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How soon after breast surgery can I be fitted with a prosthesis?

About six to eight weeks after breast surgery it will be time to see the postmastectomy fitter. Women who experienced breast conserving surgery will also benefit from a postmastectomy fitting as there are partial prostheses to help fill in the missing portion of their breast and provide symmetry. 


What is the expected lifetime of a silicone breast prosthesis?

Amoena®, Trulife®, and American Breastcare® silicone breast prostheses are warranteed against manufacturer’s defects for two years from the date of purchase. The warranty does not cover damage to the prosthesis from punctures or erosion to the skin of the prosthesis from perfume or lotions. Premium breast prostheses may last longer than two years with proper care. It is still a good idea to see a Certified Mastectomy Fitter yearly to have a fit assessment, as women’s bodies change with age and weight.


My prosthesis feels heavy.  Is it too large?

The first thing to evaluate in this situation 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 prosthesis and hold it snugly against the chest wall, then the straps of the bra end up supporting the weight of the prosthesis and pulling down on the shoulder area.


Is a lighter weight breast prosthesis appropriate for me?

Many women who cannot tolerate a weighted silicone prosthesis find that a light weight prosthesis is much more comfortable. Some medical conditions such as lymphedema or osteoporosis of the spine warrant a light weight prosthesis.


I had a lumpectomy, breast conserving surgery or reconstruction. Is there a prosthesis for me?

The Balance™ family of breastforms are partial prostheses or "shells," made of the same high quality silicone used in premium Amoena® prostheses. The difference is that Balance™ is much thinner, and can go over a breast that just needs a little more fullness in front or on the side to provide symmetry.  The triangular model #533 and the teardrop model #531 from Trulife® may also do very well in making the silhouette more even and natural.


How do I clean my breast prosthesis?

Amoena® Soft Cleanser and TruKleen® by Trulife® are recommended for daily use. Skin oils can break down the outer skin of a breast prosthesis and shorten the useful life of the prosthesis. It is a good idea to clean the prosthesis every night and store it in it’s cradle.


Is there any way to make wearing my breast prosthesis cooler in warm weather?

Wearing the breast prosthesis inside the bra pocket keeps the prosthesis off the skin. This creates more ventilation to evaporate perspiration. Another solution is to wear a CoolPad® to block the heat transfer from the prosthesis to the chest wall. Some women claim that a lighter weight prosthesis feels cooler. It is very important to wear a bra that supports the breasts and prosthesis and keeps them from resting on the abdomen, as constant moisture in this area can create skin irritation. You can also try the new climate control breast form by Amoena. It uses Phase Change Material (PCM) technology to keep a woman cool when her body temperature rises and keeps her warm when her body temperature lowers. It is personal comfort.


What is lymphedema?

Lymphedema can strike anyone who has lymph nodes that have been damaged or removed. It seems to hit breast cancer patients in higher numbers, especially in those who have nodes removed from the underarm area.

To understand what lymphedema is, it helps to know that the word is derived from a combination of the words “lymph” and “edema.” “Lymph,” also known as lymphatic fluid, is the mostly clear fluid that carries white blood cells through your lymphatic system. You probably already know that your circulatory system is an intricate system of blood vessels made up of arteries, veins, and capillaries designed to circulate blood to all areas of your body. In the same sense, your lymphatic system is a network of vessels and nodes that allows lymphatic fluid to interact with body tissues and the bloodstream, providing the lymphocytes that are a keystone of your immune system. “Edema” is the medical term for swelling anywhere in the body that is caused by a buildup of fluids. Therefore, “lymphedema” is, literally, a buildup of lymph that causes swelling in the body.

There are two types of lymphedema: primary and secondary. Primary lymphedema, whose causes are poorly understood, can occur at birth or appear well into adulthood. It can also be caused by defects that develop in the circulatory system. But the type of lymphedema most likely to affect breast cancer survivors is known as secondary lymphedema. Secondary lymphedema is more common than primary lymphedema and can be caused by any kind of trauma to the lymphatic system.


To clearly understand what happens in lymphedema, it helps to think of the lymphatic system as a series of very busy roads that effectively route traffic only when all roads are open. Then, think of what would happen if some of these roads were closed, removed or otherwise became impassable while the level of traffic stayed the same. Lymphedema occurs when lymphatic fluid can no longer travel effectively through a segment of the lymphatic system and instead spreads into the surrounding tissues, causing swelling.


During surgery for breast cancer, it is almost certain that one or more lymph “nodes” and lymph vessels will be removed to determine if and how far the breast cancer has spread. This removal causes routing problems for lymph in the affected area. To further complicate matters, breast cancer patients are also frequently treated with radiation, which causes scarring and other damage to lymph nodes and vessels. In both cases, the injury caused to the lymphatic system places breast cancer patients at increased risk for lymphedema.


In some breast cancer patients, lymphedema develops almost immediately after surgery. In others, it may develop many years later or not at all. It is not possible to predict who will and who won’t face this disorder, but it is estimated that between one quarter and one third of all breast cancer survivors will eventually be affected.


Though there is currently no cure for lymphedema, it can be controlled through treatment if detected early, and there are steps that can be taken that may lessen the risk of developing lymphedema in the first place. Breast cancer survivors should familiarize themselves with the symptoms of lymphedema, and learn the tips that may help to prevent it altogether.


What can I expect during a fitting?

About six to eight weeks after breast surgery it will be time to see the postmastectomy fitter. Women who have had a mastectomy should be able to wear a weighted prosthesis at this time since their incision should be healed. Women who experienced breast conserving surgery will also benefit from a postmastectomy fitting as there are partial prostheses to help fill in the missing portion of their breast and provide symmetry. Most private insurance plans have coverage for breast prostheses and bras. If you are in doubt about your coverage, call the number on your insurance card and inquire.



Who does the fitting?
The fitters are trained, usually by manufacturer based education programs, to fit bras and prostheses. They are taught which products do best with different surgery types, and how to handle special circumstances.


The Fitting Process

  • The fitting should be conducted in a manner that offers the person being fitted complete privacy.

  • The fitter will first assess the condition of the skin at the mastectomy site. There should be no drainage or open wounds at the surgery site, or incision. Either of these conditions would require permission from the patient's physician before proceeding.

  • The fitter will determine the proper bra size by taking measurements at strategic points on the chest wall and around the rib cage. The fit of the bra is crucial to how well the prosthesis will be tolerated, and how natural the fit will be. Mastectomy bras today are pretty and feminine while providing the support needed to keep the prosthesis in the correct position. Although it is not mandatory to use a mastectomy bra with a breast prosthesis, it is recommended.

  • Next comes the prosthesis recommendation. The fitter will note the shape and drape of the existing breast and try a prosthesis that best approximates those dimensions. Prostheses come in many shapes such as teardrop, triangle, heart shaped and more. Some taper the material into the underarm area to fill in missing tissue there. Some prostheses are symmetrical, meaning they can be worn on either side, others are asymmetrical and are side specific. For women who have lost both breasts, the fitter will make suggestions for prostheses that are flattering to the patient's body dimensions.

  • The fitter will place a soft drape or smock on the patient and show the patient in the mirror how she looks with the products chosen. This is where the patient should let the fitter know if she is happy with the results or if she wants to try something else. Most importantly, if the patient is not happy, speak up!

  • A yearly visit to the fitter is a good idea. Women's bodies change in response to hormonal changes and weight fluctuations. The natural breast will change in response to these factors and a change in prosthesis may be needed to maintain symmetry.

  • Before leaving the fitter's facility, instructions on use and care as well as the retailer's return policy should be given.

  • Premium prostheses such as Amoena and Trulife have a two year warranty against manufacturer's defects. This does not include punctures or damage from perfumes or other personal toiletry items. Daily cleaning with Amoena Breast Form Wash or TruKleen by Trulife and storing the prosthesis in it's cradle when not in use should keep your Amoena prosthesis great shape.


Does my bra fit?
It has been estimated that 80% of women wear the wrong size bra. Many women are not aware that they do not have to endure discomfort from their bras. With a simple fitting, a Certified Mastectomy Fitter can recommend which size and style will flatter a women’s appearance and provide the most comfort. Whether or not a women has had a mastectomy, a good fitting bra is essential for creating symmetry.


The National Lymphedema Network (USA) states that poor fitting bras can contribute to the formation of lymphedema of the upper extremities. Bra straps and bands that are too tight are thought to impede the flow of lymph fluid. It is important that someone who has a history of lymphedema have at least yearly bra fittings.

What makes a good fitting bra?

To get a good fitting bra you must first start with a good fitting. The fitter should measure and make recommendations for optimum fit and comfort of her patients. To assess the fit of the bra, the fitter will evaluate all the components of the bra to see how they match with the wearer’s unique proportions. Among these are:


The Band
The bra band should be snug, but not tight, using the middle set of hooks to fasten the bra. With a proper fit, you should be able to comfortable insert 1 finger under the band on each side, front and back. If the band rides up in the back, this is an indication the bra is too large.


The Straps
The straps should fit snugly without cutting into the shoulders and sides. You should be able to get two fingers under the strap. Women who are large breasted or who have a history of lymphedema should always wear a bra with wider straps. Underwire bras can help take some of the pressure off the shoulders.


The Cups
The cups should not force the breasts toward the sides or the center. There should be a natural looking separation of the breasts. The center portion of the bra should lie flat against the chest wall between the breasts. If the cup is not filled out or if it wrinkles, a smaller size, fiberfill or contour cup may work better. If the breast tissue overflows, a larger cup or a style with more coverage should be suggested. The underarm area should lie smooth without cutting into the flesh.


To test the fit of a bra sit down and take a deep breath. Does the bra feel binding? If so, it may be too snug. Too loose? Maybe the next size down would be better. Bras should be washed by hand with delicates wash or a mild soap and line dried. This will prolong the elasticity of the fabrics. The average lifespan of a bra is four to six months of daily use. Proper care extends the lifetime of the garment.

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