Below we have answered some common questions that will help you understand more about breast prostheses and reconstruction.
Learn more about:
- Why is this information important?
- What is a breast prosthesis?
- What is a breast reconstruction?
- Breast reconstruction in men, trans people and gender diverse people
- Do I need to have a prosthesis or a breast reconstruction?
- Can I go flat?
Why is this information important?
This information is designed to help you understand your options before or after surgery for breast cancer.
Your breasts may symbolise femininity, nursing a baby and sexual attractiveness. Having part of or the whole breast removed may affect how you feel about yourself, or your confidence.
Before or after surgery you may think about whether, and how, to restore your breast shape. You may consider an external breast prosthesis, a breast reconstruction or staying flat. A breast prosthesis is a synthetic breast worn inside a bra. It is also called a breast form. Breast reconstruction surgery creates a new breast shape using your own tissue and skin, an implant or a combination of both.
We hope this section will help you weigh up the benefits and drawbacks before making a decision.
What is a breast prosthesis?
An external breast prosthesis (plural: prostheses) is a synthetic breast or part breast that replaces the shape of all or part of your breast. It is also called a breast form.
You may choose to wear a prosthesis after you have had surgery to remove the whole breast (mastectomy) or part of the breast (breast-conserving surgery, lumpectomy or wide local excision). Most breast prostheses have the shape and feel of a breast, and may weigh the same or be lighter. You can put these prostheses into specially made pockets in bras, activewear, swimwear and sleepwear or attach them directly to the skin.
What is a breast reconstruction?
A breast reconstruction is an operation to make a new breast shape. You may have a breast reconstruction at the same time as the mastectomy (immediate reconstruction) or at a later time (delayed reconstruction).
The aim of a breast reconstruction is to make a breast that looks as similar to your original breast shape or other breast as possible, but the reconstructed breast will not feel or look exactly the same.
There are 2 main types:
- implant reconstruction, using a sac filled with either silicone gel or saline
- flap or autologous reconstruction, using skin, muscle and fat from another part of your body.
Breast reconstruction in men, trans people and gender-diverse people
Anyone with breast tissue can develop breast cancer, and may have breast reconstruction after a mastectomy.
Some of the information in this booklet may be relevant to men, trans people and gender-diverse people who are considering having a breast reconstruction. For information specific to your situation, speak to your doctor.
Men with breast cancer can find information on Cancer Australia’s Breast Cancer in Men.
Breast Cancer Network Australia (BCNA) also has helpful information and personal stories about men with breast cancer. Visit bcna.org.au and search for “breast cancer in men”.
See also LGBTQI+ people and cancer.
Do I need to have a prosthesis or a breast reconstruction?
It is your decision whether you choose to stay flat, wear a prosthesis or have a reconstruction after surgery. Only you can choose what feels right. You do not need to decide immediately.
Unless you want to have a reconstruction at the same time as the mastectomy, there is no time limit on when you must decide. See your doctor as many times as you want before making a decision and ask questions about what to expect. You may be able to have a temporary tissue expander to give you time to decide.
Some reasons for using a breast prosthesis or having a breast reconstruction after a mastectomy include:
Replacing the weight of the removed breast – When a breast is removed, the body is no longer balanced. This can cause a slight curving of the spine and a drop of the shoulder on the affected side. Lower back and neck pain may develop over time. Regardless of your breast size, you can have issues with balance after having a mastectomy. A prosthesis or reconstruction can help with balance.
Creating symmetry when wearing clothing – Breasts are not often identical in size – the muscle and tissue on each side of the body are different. After a mastectomy on only one side, these differences are usually more noticeable. A prosthesis or breast reconstruction may help you feel and look more even on both sides (symmetrical).
Restoring self-esteem – Re-creating the shape of your breasts with a prosthesis or reconstruction may help to boost your confidence – including sexual confidence – about the way your body looks after a mastectomy. Learn more about body image and sexuality issues.
Adjusting to the diagnosis and treatment – Wearing a prosthesis or having a breast reconstruction may help you cope better with the cancer diagnosis. You might feel like you are taking control of the way you look.
Can I go flat?
If you decide not to have a reconstruction or wear a prosthesis, you may consider going flat – also called staying flat or living flat. This may be because you are comfortable with how your body looks after surgery for breast cancer.
Your reasons for going flat may include:
- to avoid having more surgery and any potential complications
- for an easier, faster and less complicated physical recovery
- to return to your usual activities as soon as possible
- to avoid the possible side effects of breast reconstruction
- not liking the feeling of a reconstructed breast
- not wanting to wear a prosthesis
- to avoid the costs of surgery, new mastectomy bras or prostheses
- to avoid possible weakness in the shoulder that may make some activities, such as tennis and golf, more difficult
- not being suitable for a reconstruction.
If you decide to go flat, talk to your breast surgeon about what the finished result will look like. Ideally, the surgeon would remove extra skin, excess tissue and pockets of fat, and then smooth out the remaining tissue and skin to create an even chest wall. Your breast surgeon may work with a reconstructive (plastic) surgeon to achieve a good result.
I chose to go flat after my double mastectomy and 2 years later, I’m happy with that decision. I felt that my breasts couldn’t be replaced, so I needed to learn to live with my new shape. It was helpful to talk to my surgeon and see photos of other people who had gone flat.
Beth
Podcast: Sex and Cancer
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Key resource
Download a PDF booklet on this topic.
More resources
Dr Jane O’Brien, Specialist Oncoplastic Breast Cancer Surgeon, St Vincent’s Private Hospital, VIC; Clare Bradshaw, Clinical Nurse Consultant, Breast Assessment Unit, Fiona Stanley Hospital, WA; Rene Hahn, Consumer; Sinead Hanley, Consumer; Dr Marc Langbart, Specialist Plastic and Reconstructive Surgeon, Randwick Plastic Surgery, NSW; Melanie Law, Consumer; Sally Levy, Consumer; Annmaree Mitchell, Consumer; Ashleigh Mondolo, Breast Cancer Nurse Clinical Consultant, Mater Private Hospital Brisbane, QLD; Rochelle Osgood, Clinical Nurse Consultant – McGrath Breast Care Nurse, Sunshine Coast University Hospital, QLD: Dr Kallyani Ponniah, Head of Department, Breast Centre, Sir Charles Gairdner Hospital, WA; Meg Rynderman OAM, Consumer; Sarah Stewart, Breast Care Nurse, The Royal Women’s Hospital, VIC; Erin Tidball, 13 11 20 Consultant, Cancer Council NSW; Jane Turner, Senior Exercise Physiologist, Sydney Cancer Survivorship Centre, Concord Cancer Centre, NSW.
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