Monday, October 6, 2014

After Mastectomy: How to Choose Breast Forms That Work for You








Reconstruction techniques after a mastectomy have improved greatly in recent years, with much more natural results.

Even so, about 37 percent of women choose not to have reconstruction, according to a study published in February, 2014 in the Journal of Clinical Oncology.
Some women simply choose to live without a breast, or even the appearance of a breast. However, many others turn to breast forms — also known as prosthetic breasts or external breast prostheses.

These breast forms can make it easier to wear clothes more attractively and, some women say, feel more like your old self. 
They're not perfect — and they won't feel exactly like a breast, of course.
Here's what to know if you're considering this option.

Every woman has a personal reason, or many, for deciding to forego breast reconstruction, says Elizabeth Chabner Thompson, MD, MPH, a radiation oncologist in New York, Everyday Health columnist, and entrepreneur who has launched a company producing post-surgery bras and other products.   

"Age is a huge factor," she says. Sometimes older women will simply decide not to, that it's not important to them. If a patient has a serious heart condition or other medical issues, she may decide she doesn't want to undergo another surgery after the mastectomy, unwilling to face the risk every surgery carries, Dr. Thompson explains.
Thompson's mother, Davi-Ellen Chabner, a teacher and writer from Boston, had a mastectomy in 1993. For her, the main focus was the mastectomy surgery. "I was very focused on getting rid of the breast cancer," says Chabner, now 70.
After much thought, she says, ''what I came away with was, 'I really didn't want anything else.''

She has been using breast forms ever since. She's remained very active, finishing 10 marathons in addition to her professional accomplishments, but is the first to acknowledge that the prostheses aren't perfect — and can be a bother. She's sometimes removed the form before crossing that finish line because it was sliding around and distracting her.
Among the types of breast forms or prostheses for use after a mastectomy are:
  • Silicone forms, worn externally.
  • Nonsilicone forms, made of foam or fiberfill, designed to be worn right after a mastectomy or during workouts or hot weather.
  • Attachable breast forms, designed to be fastened to the chest wall by using adhesive strips.
  • Soft camisoles with breast forms for wearing right after a mastectomy, while healing is in progress. The form is placed into a pocket in the camisole.
After a mastectomy, you become asymmetrical, says Kathleen Gill Bazazi, a fitter of breast forms at Massachusetts General Hospital. The breast form can help you regain some symmetry, she says, and in the process help your posture — perhaps along with your self-image.

"If you have one breast, you aren't even, and you are going to favor one side," she says. As a result, ''you limit your clothing choices and your lifestyle."
Many women tell her having the breast form there helps them feel more comfortable with what they are wearing.

She finds having the right form can help women stand up straighter, with less spinal curvature and perhaps less muscular pain from slouching.

The forms come in many different materials, styles, and sizes, with nipples or not. Experts suggest you go to a mastectomy boutique or specialty shop that has on staff certified fitters as well as the breast prostheses, along with post-mastectomy bras, swimsuits, and camisoles. Ask your surgeon for a good referral.

Wear a top that is form-fitting, such as knit, so you will be able to see exactly how the forms will look under clothing.

It's crucial to have an individual fitting, Bazazi says. When trying on forms, she says, focus on fit, comfort, and style — and whether both sides match.
"Unless you have had extreme surgery, 90 percent or more of women can achieve symmetry [with the breast forms]," she says.

Right after the mastectomy, she recommends women get a soft foam form, with no weights, to allow the body to heal.

Four to six weeks or so later, she says, women can begin to look at the weighted silicone and other forms. ''The silicone breast prostheses are weighted to match the breast on the other side," she says.

Be patient while shopping, say Bazazi and Thompson. It takes time to find the best prosthesis for you. "It's like finding a favorite bra that you like," Thompson says.
Don’t be pushed into buying one brand or a form you aren’t sure fits well, Thompson advises. 

You may also want a mastectomy bra or you may want pockets sewn into clothes so the form can be slipped in.

In general, Medicare and some insurance plans cover the cost of the bra and form, provided you have a prescription from your doctor. However, plans typically limit the coverage, paying only for a certain number of forms and bras within a specified time. Check before you shop.

Before buying, ask about the form's life expectancy. Be sure you know how to wash it and how often.

A final tip, from one who knows: "If it doesn’t feel right, take it back," says Chabner. 

Everyday Health




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