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For those women who do not want to undergo breast reconstruction, but who want to restore the natural outline of a partially or totally removed breast, a wide range of artificial breasts, known as prostheses, is available. Breast prosthesis is worn inside the bra, and can be matched to the other breast to make it indistinguishable in terms of size and shape.

Temporary prostheses

Immediately following surgery, you can wear a light, temporary prosthesis which will not press on your wound as it heals. A breast care nurse or other specialist nurse will probably help you to choose and fit a prosthesis of this type before you leave hospital.

The commonly used breast shapes are washable and have a lightweight fibre filling which can be added to or removed to make them the correct size. They are simply placed inside your bra, which should be as good a fit as possible so that the breast shape remains in place. Safety pins or press studs sewn on to the prosthesis and the inside of the bra cup will also help to prevent the shape from becoming dislodged as you move.

Permanent prostheses

Some 6 to 8 weeks after your operation, or following your course of radiotherapy if you have one, a heavier, permanent prosthesis can be fitted to match the size, shape and weight of your other breast. These prostheses are made from silicone and have a skin-like texture. Although a silicone breast shape can be placed in a cotton cover which can be removed for washing, it is more often left uncovered so that it can mould to the contours of your chest wall. The cover may be useful if the prosthesis becomes uncomfortable or when you are hot.

Some manufacturers make tinted prostheses for women with darker skins, and the breast care nurse should be able to advise you about how to select the right one for your skin colour.

All the permanent prostheses have a nipple outline, but it is now also possible to have a separate, textured and pigmented nipple and areola, and these are available in a variety of skin tones. The nipple may be attached permanently or semi-permanently to the breast form. Although the artificial nipples look very realistic, they cannot retract and become erect, and it is now possible to have an artificial nipple to place over the nipple of your other breast so that the two always match.

A self-supporting prosthesis which will stick to their chest wall can be worn by women who do not have large breasts. Modern self-supporting prostheses allow complete freedom of movement and will stay in place during the playing of sports such as tennis, horse-riding and swimming. Sports bras are only normally necessary for any particularly vigorous sporting activity. This type of prosthesis is useful for women who do not normally wear a bra, and those who like to wear strapless dresses.

The silicone which gives the breast shape bulk and form may be too heavy for women with large breasts. Although pads worn under the bra straps may help to take some of the weight off the shoulders, if this does not improve the situation, a lighter prosthesis can be used, for example one with a silicone front and a foam-type infill. If you have any problems of this sort, your breast care nurse should be able to sort them out for you.

It is quite all right to swim when wearing a silicone prosthesis, as it should not be affected by sea water or the chlorine in a swimming pool. However, it is probably advisable to rinse it in tap water and dry it afterwards.

Although silicone prostheses do not usually cause skin irritation, they can occasionally do so, and if you do develop a rash or skin reaction, the breast care nurse should be able to advise you or refer you to a consultant if necessary. Very rarely, a woman may have an allergic reaction to her breast form, but skin irritation is more likely to be due to a sweat rash.

Take your time when making your choice of prosthesis. There is a wide variety available, and you should be able to find exactly the right one, particularly if you are assisted by an experienced fitter. A tight-fitting T-shirt or sweater worn when trying the different prostheses will enable you to get a good idea of their shape and how well they fit.

If you have had a partial mastectomy which has left your breasts only slightly different in size and shape, the breast care nurse will be able to augment your affected breast with a silicone shell, rather like a thin, scooped out prosthesis. Alternatively, a small, light prosthesis can be stitched into your bra cup.

Partial prostheses are also available in a range of sizes and shapes.

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