We are pleased to offer you Mastectomy Care products created for a feminine and positive self image. Our Mastectomy Care Products take women from the hospital, through healing and back to a busy and active lifestyle with comfort and confidence.

Your Initial Fitting
Your first, or initial fitting will usually take from an hour to an hour and a half. It is important for you to be relaxed so you can spend the time necessary to receive the very best fit. It is also a good idea to take one or two of your own shirts or blouses to try on with the different bras and prostheses. If you have a favorite bra take it along too. Some styles can continue to be useful if you sew in your own pocket.

There are many prostheses manufacturers and choices. It is always best to rely on the expertise of a trained, certified mastectomy fitter to help you find the most suitable brand and style for you.

When your physician decides that you are ready for your fitting, he or she will write a prescription for your bras and prostheses. You may be required to request a referral from your insurance company. It is recommended that you call ahead to schedule an appointment for your first fitting, and at this time discuss your insurance coverage with the fitter.

Balance and Proper Alignment
The fitting of a weighted breast prosthesis is not only for aesthetic appearances. It is also a therapeutic measure that replaces the weight of the lost breast. When fitted with a breast prosthesis that matches in size to the remaining breast, the weight equilibrium of the body is kept in balance.
 

Because the human body is essentially symmetrical, imbalance occurs when a breast is removed. This imbalance can cause one shoulder to drop downward and inward and the other shoulder to rise up. When the body is not properly aligned, back, shoulder and neck discomfort may result. A weighted silicone prosthesis restores the body's natural balance by approximating the remaining breast in weight and balance, as well as in projection and width. The silicone breast prosthesis warms to a woman's body temperature and appears smooth and natural under clothing. The weight of the silicone prosthesis will also keep the bra from riding up or pulling to one side.
 

NOT wearing a breast prosthesis, or wearing one that is too heavy or light can result in the following:

• Spinal curvature
• Shoulder drop
• Muscle contracture, with accompanying discomfort (neck or back pain).
• Balance problems

How soon after a mastectomy can a weighted prosthesis be worn?
As soon as a woman receives permission from her physician, she can schedule an appointment to be fitted with a silicone prosthesis. Usually in four to six weeks. Swelling and tenderness should be gone. You and your Doctor will decide when you are ready. During this recovery time, Contour Solutions recommends the Amoena Camisole and Amoena Foam Form which are ideal for wearing home from the hospital and throughout healing.

Medicare Reimbursement
Mastectomy Care products are covered by Medicare and most private insurance carriers. You should receive a prescription from your Doctor for all garments, prosthesis and surgical bras. (Surgical bras are specifically designed with inside pockets to securely hold a weighted prosthesis.)

In order to complete the Medicare and/or insurance billing for you, the fitter will need a prescription, your physician's name and address, your Medicare card and/or your insurance I.D. card.

Medicare currently pays 80% of the allowable towards four specialty bras every year, regardless of when you had surgery. They will also pay 80% of the allowable for one prosthesis per year for each surgery side, if needed. If you have secondary insurance, they may pay the 20% Medicare does not cover. If you have private insurance, an HMO or PPO, check with your carrier to see how often they will replace your bras and prostheses and how much they will pay.

 

Adjuvant therapy:  Treatment given that enhances the effectiveness of the primary treatment.

Areola:  The area of dark-colored skin around the nipple.

Axilla:  The underarm.

Benign tumor:  A growth that is not cancer; it does not spread to other parts of the body.

Bilateral mastectomy:  Removal of both breasts.

Biopsy:  The removal of a sample of tissue that is looked at under a microscope to see if cancer cells are present. An excisional biopsy is surgery to remove an entire lump. An incisional biopsy, which is less commonly performed for breast tumors, removes part of the tumor. Removing tissue or fluid with a needle is called needle biopsy or needle aspiration.

Cancer:  A term for more than 100 diseases that have uncontrolled, abnormal growth of cells. Cancer cells can spread through the bloodstream and lymphatic system to other parts of the body.

Carcinoma:  Cancer that begins in the lining or covering of an organ.

Carcinoma in-situ:  Cancer that involves only the cells in which it began and has not spread to other tissues. Lobular carcinoma in-situ is found in the lobules of the breast. Ductal carcinoma in-situ (also called intraductal carcinoma) arises in the ducts.

Chemotherapy:  Treatment with anti-cancer drugs.

Clinical trials:  Studies of new cancer treatments. Each study is designed to answer scientific questions and to find better ways to treat patients.

Cyst:  An abnormal sac within a tissue or organ, usually filled with fluid.

Duct:  A tube in the breast through which milk passes from the lobes to the nipple.

Estrogen:  A female hormone.

Hormone therapy:  Treatment of cancer by removing, blocking or adding hormones.

Hormones:  Chemicals produced by certain glands in the body. Hormones control the way certain cells or organs act.

Lobe:  A part of the breast; each breast contains 15 to 20 lobes.

Lobule:  A subdivision of the lobes of the breast.

Lumpectomy:  Surgery that removes the breast lump; usually followed by radiation therapy.

Lymph:  An almost colorless fluid that bathes body tissues and carries cells that help fight infection.

Lymph nodes:  Small, bean shaped organs located along the lymphatic system. Nodes filter bacteria or cancer cells that may travel through the lymphatic system. Also called lymph glands.

Lymphatic system:  The tissues and organs (including the bone marrow, spleen, thymus and lymph nodes) that produce and store cells that fight infection and the channels that carry lymph fluid.

Lymphedema:  Swelling of the hand or arm caused by extra fluid that may collect in tissues when lymph nodes are removed or blocked. .

Malignant:  Cancerous.

Mammography:  An x-ray procedure to detect breast tumors.

Mastectomy:  Surgery to remove the breast.

Menopause:  The time of a woman's life when menstrual periods stop; also called 'change of life.'

Metastasis:  The spread of cancer from one part of the body to another. Cells in the metastatic tumor (the second tumor) are like those in the original cancer.

Oncologist:  A doctor who specializes in treating cancer.

Palpation:  A simple technique in which a doctor presses lightly on the surface of the body to feel the organs or tissues underneath.

Pathologist:  A doctor who identifies diseases by studying cells and tissues under a microscope.

Progesterone:  A female hormone.

Prosthesis:  A breast form worn under clothing. (Prostheses is plural.)

Radiation therapy:  Treatment with high-energy rays from x-rays or other sources to kill cancer cells.

Staging:  The process of learning whether cancer has spread from its original site to another part of the body.

Stereotactic Needle Biopsy:  A method of needle biopsy that is useful in cases in which a mass can be seen on a mammogram, but cannot be found by touch. A computer maps the location of the mass to guide the placement of the needle.

Thermography:  A test that measures and displays heat patterns of breast tissues. Abnormal tissue generally is warmer than healthy tissue.

Tumor:  An abnormal mass of tissue.

Ultrasound:  A test that bounces sound waves off tissues and converts the echoes into pictures. Tissues with different densities reflect sound waves differently, making it possible to tell the difference between a fluid-filled cyst and a solid mass.

Unilateral mastectomy:  Removal of one breast.

 

• Modified Radical Mastectomy

  A Modified Radical Mastectomy is when the entire breast is removed including the nipple. The surgeon will remove some or all of the underarm lymph nodes (particularly those closest to the breast) to determine if the cancer has spread beyond the breast itself. It may be followed by radiation therapy.

• Lumpectomy

  In this procedure, the entire breast lump and portion of normal adjacent breast tissue is removed, followed by radiation therapy. The surgeon may remove and test some of the underarm lymph nodes to check for the spread of cancer. Because this procedure avoids the hollowness beneath the collarbone created by more extensive surgery, it permits women to wear clothes with lower necklines and can also make breast reconstruction easier.

• Prophylactic or Subcutaneous Mastectomy

  A preventive mastectomy for women who are at high risk of breast cancer. The surgeon removes as much of the breast tissue as possible, leaving the skin which has been covering the breast and the nipple intact. The surgeon then reconstructs the breast by placing an implant under the pectoral muscle, or using the patient's own tissue on top of the muscle.

• Mastectomy with Reconstruction

  Women who have a mastectomy or lumpectomy have the option to choose surgical breast reconstruction. This can be done either at the time of mastectomy (immediate reconstruction) or later (delayed reconstruction). Breast reconstruction can be performed using either 'implants' or the patient's own tissue. Immediate reconstructive surgery may not be an option for all patients. It is best to talk with your doctor about the specifics of these procedures to see if they are appropriate. The doctor may refer a woman to a plastic surgeon for more information or consultation.

  There are basically two types of reconstructive operations - Simple (non-flap) and flap. The choice depends on the amount and suitability of tissue remaining at the mastectomy site and the requirements to match the opposite breast. The physician will discuss these alternatives with the woman in terms of what best suits her situation.

  • Simple Non-flap: A simple non-flap procedure is used when there is enough existing local healthy tissue, including muscle, at the mastectomy site. The breast implant is placed under the muscle. The existing mastectomy scar is usually used for the incision, or the surgeon may need to make a new incision. Another version of a non-flap procedure involves the tissue expansion technique. A temporary internal breast implant called a tissue expander is placed in the position of the new breast, and a saline solution is injected into the expander over a period of weeks. When the skin & muscle has stretched to the desired amount, the temporary implant is removed, and a permanent one inserted in its place.
    
     
  • Flap Procedure: (also called Myocutaneous Flap): Several types of flap procedures are used when it is necessary to transfer additional tissue to the mastectomy site to reconstruct the breast. Latissimus Dorsi procedure is the most frequently used. This technique transfers the muscles and skin from the patient's back when additional tissue is needed after a mastectomy. It may also be used to provide soft tissue cover for a breast implant. When this technique is used, there is usually an elliptical-shaped scar at the site of the reconstruction and a linear scar on the back, which can often be covered with a bra.

 

• What Your Coverage May Include

  Many women do not take advantage of their Medicare and private insurance reimbursement Benefits for the specialty products they may need because they do not know they are eligible.

  Following a diagnosis of breast cancer and subsequent surgery, your coverage may include:

  • Recovery Camisoles, breast prostheses and bras for all women who have a mastectomy.
  • Light weight foam form or a temporary prostheses and pocketed bras during the stages of breast reconstruction.
  • Permanent prostheses and bras for women who complete breast reconstruction and may require enhancement to create a balanced appearance.
  • Prostheses and bras for lumpectomy surgeries which result in one breast appearing smaller in size.
  
  

  It is best to check with your insurance company before your fitting to determine benefit coverage. Your insurance may require preauthorization before they will pay.

  Other coverage could include:

  • Medicare benefits allow for the purchase of bras every year and a breast prosthesis for each surgery every two years, regardless of when you had surgery. They will replace more often if there is a significant change in the body or weight.
  • Most private insurance companies, HMOs (Health Maintenance Organizations), and PPOs (Preferred Physician Organizations) will cover the cost of the first prostheses and bra fitting, then replacement prostheses and pocketed bras at least every two to three years.
  
  

  What You Will Need to Take with You When You Go to Purchase Specialty Products

  • Your Medicare red-white-blue card
  • Your primary insurance ID card, and secondary ID card if you have additional coverage.
  • If applicable, a precsription or a referral from your primary care physician
  
  

  For a prosthesis and bra fitting it is always best to call ahead and make an appointment.

 

• What is a Silicone Breast Prosthesis

  External silicone breast prostheses, or breast replacements, are filled with silicone gel (silicone produced in a semi-solid, semi-liquid state.) The outer clear coating, or skin, is usually polyurethane, which protects the silicone, and makes the prostheses more durable. This medical grade silicone is non-toxic and safe, and is not the same silicone composition that internal breast implants are made of. Silicone warms to body temperature, and closely resembles natural tissue in softness, drape and appearance. Most prostheses are flat on the back, but some are designed with concave or hollow backs and may be lighter in weight.

  Breast prostheses come in a variety of styles, shapes and sizes to accommodate the needs of each individual. When a woman is measured by a trained and certified mastectomy fitter, the prostheses will equally match the remaining natural breast in size and weight.

• Cost & Shapes

  A silicone prosthesis ranges in cost from approximately $190. to $470. What is the difference? The most obvious differences are in their shape and the brand name of the manufacturer.

  • Teardrop Style

    The teardrop style is designed to fill in under the arm when more extensive tissue has been removed. It can be worn on either the right or left side (symmetrical).

  • Heart & Triangular Shapes

    The heart and triangular shapes are also symmetrical and have no underarm extension. These two styles often work well for the newer surgeries where less tissue has been removed under the arm.

  • Asymmetrical Breast Prosthesis & Self-Supporting Styles

    Generally more expensive, an asymmetrical breast prosthesis is designed specifically to be worn on the left or the right side. This style has two 'wings' or extensions to offer more coverage under the arm and on the upper chest wall. Oftentimes these will provide a more individualized fit. Another option is a self-supporting style of breast prosthesis, which is available in both asymmetrical and symmetrical styles. These prostheses use a skin support system, which allows the prostheses to be worn directly against the chest wall, so there may be no need for special pocketed bras (women with sensitive skin or adhesive sensitivity need to use caution when considering).

  • Partials Or Shells

    Another option are partials or shells, available to be worn by women who have had a lumpectomy, or to correct unevenness which may have resulted from implant surgery or reconstruction.

  • Other Types of Silicone Breast Prostheses

    There are whipped silicone prostheses that are lighter in weight, styles with foam backing and styles that have a more liquid gel on the side worn closest to the body. This might be of particular comfort to women who have more scarring or more tissue absent on the chest wall. In addition there are durable prostheses which are chlorine and heat resistant specifically for swimming and hot tubs.

    Some manufacturers also offer breast prostheses specifically color created to blend with, and more closely match darker skin tones.

  • Alternatives for Sleep & Leisure

    In addition to weighted silicone prosthesis there are many styles of soft and lightweight non silicone options for sleep and leisure.

• The Importance of Proper Alignment

  When a woman has one breast removed and does not wear a breast prosthesis, the body is out of balance. If you have ever worn a shoulder purse shopping, you know that by the end of the day the weight of the bag has caused pressure and stress on that shoulder, the neck and back. This same theory applies to a woman with one breast. Having weight on one side of the body only, pulls the skeletal structure out of alignment, regardless of how small or large breasted a woman is.

• Pocketed Bras

  A breast prosthesis should be worn in a pocketed bra designed specifically to securely hold it in place. Some non-pocketed bra styles can be adapted, or pockets can be sewn into pre-molded cups. It is best to discuss different options with your mastectomy fitter.

• Warranties & Prostheses Care

  Most manufacturers of silicone prostheses offer an industry standard two-year, limited warranty. Be sure to fill out and mail your warranty card to the manufacturer immediately. This warranty covers replacement only if the damage to the prostheses is due to a manufacturing defect. The warranty does not cover damage resulting from punctures, fingernails, pet claws, or other sharp objects, so it is important that the prostheses be handled with care. The silicone prostheses will come with a soft, cotton, removable cover, that is molded to fit the shape of the prostheses. The cover will help to protect the prostheses as it is handled.

  The silicone gel inside the prostheses is very dense. If the prostheses should become damaged by a puncture or tear the silicone will not spill out. It could be several days or even weeks before noticed, usually by discovering a thick, sticky residue on your hands or on the inside of the cloth cover. Once a prosthesis begins to leak, it needs to be replaced. Some women will temporarily 'patch' the defective area with tape and continue to wear the prostheses. This is not recommended. A defective prosthesis must always be returned to the location where it was purchased, never directly to the manufacturer.

  A silicone breast prostheses will last anywhere from two to five years. The prostheses can be removed from the cloth cover and gently hand washed with a mild soap and water, then patted dry with a soft towel. Do not scrub, use abrasive cleaners or roll in a towel to dry. When it is not being worn the prostheses should be stored in the original, molded box it was purchased in. The cloth cover can be laundered and air dried in a flat position.

  It is recommended that women have more than one breast prosthesis in case of loss or damage. A spare prostheses can be silicone, a lightweight silicone, a swim breast form, foam or cloth.

  Most women who choose to wear an external breast prostheses are very happy with the natural look and many are able to continue wearing the intimate apparel styles they have been accustomed to.

 

What is a Certified Fitter?

When you are ready for your first prosthesis and bra fitting, you will need to locate a Certified Mastectomy Fitter (CMF). In order for a fitter to become certified she must first complete extensive training. These comprehensive training classes are offered through manufacturers of post mastectomy products and accredited orthotic and prosthetic certification programs.

When a mastectomy fitter becomes professionally certified, she has met all of the criteria necessary to work independently within a defined scope of practice. In addition to learning how to select the appropriate products and correctly measure for a proper fit, the fitter also may have instruction in topics such as the different types of surgical procedures, anatomy of the breast, side effects of breast cancer treatments, and lymphedema.

• The First Step

  Call ahead to make an appointment with your fitter. At this time she will help you determine your post mastectomy medical reimbursement coverage and if you need prior authorization before your visit. Your fitter may ask you questions regarding your surgery in preparation for your appointment.

• Finding the Proper Size, Style & Fit

  A proper prosthesis fitting begins with a comfortable, precise fit in the correctly sized and styled bra. Many women are currently wearing an incorrect size because they have never had the opportunity to experience a professional fitting. After the correct size and style pocketed bra has been selected, you and your fitter will determine the size and style of breast prosthesis best suited to you. She may offer several different options and will give her opinion about ones she believes are best for you. If you have trouble deciding between two sizes of prostheses, you should probably choose the smaller size. The fitter will offer guidance and suggestions based on her experience and knowledge, but the final decision will be yours.

 

• What Is a Pocketed Bra?

  A pocketed, or sometimes referred to as a surgical or mastectomy bra is similar in many ways to the bras you may have worn in the past. There are many styles and several colors to choose from. The pocketed bra is designed to hold a breast prosthesis (silicone or other), to create a balanced and natural appearance. All mastectomy bras come with pockets sewn in on both right and left sides.

• Getting the Proper Fit
  
  A mastectomy bra is designed higher in the front and often is higher under the arms. It has special pockets sewn inside the cups to hold the prosthesis. A good fit begins with the right bra.
  
   

  When your bra is properly fitted, your prosthesis should stay securely in place and you should not notice the weight of the silicone prosthesis. When the silicone prosthesis is fitted to you, it will weigh approximately the same as your natural breast. If the prosthesis feels heavier, the bra may not be the correct size or fit. The more snug to the body the bra fits, the less weight and movement you will have, and the more support you will achieve.

  During your fitting, if there are areas inside your bra cup that the prosthesis does not fill, there are fitting aids available at minimal cost, in many shapes and sizes that can be sewn in to smooth out the folds. Some bra styles come with little pockets sewn in under the arm to hold a specific brand of fitting aid.

  When you choose to wear a lighter weight silicone prosthesis, or a fabric or foam breast form you may find that the bra will ride up, or pull to one side. This occurs when there is not an equal amount of weight on the natural side and the surgery side. The only solution is to find a breast form with more weight to hold the bra in place.

  If both breasts have been removed, you will still need to be measured and fitted for a bra in the correct circumference size. The cup size is negotiable, so you can choose to be as large or as small as you wish. It is best to keep in mind that your bust size should be in proportion to the size and shape of your body. Your fitter can help make recommendations.

  When you have completed your fitting you will want to make sure that the bra feels comfortable yet snug around the rib cage, and that the prosthesis fills the cup. Projection and fullness of the prostheses should match the remaining breast. Check to see that the bra is centered in the front, and the top of the bra cup is filled out to match the remaining breast.

• Continued Care & Fit

  Bras generally stretch with time and wear, they rarely shrink. After you have been wearing your bra and prosthesis for awhile, if the bra becomes loose fitting, or feels like it has stretched and is not offering enough support, the first thing you should do is check the adjustments. As the bra is worn and laundered, the shoulder straps may loosen causing the bra to pull downward, which affects its ability to offer lift and support. Try tightening them. If you have been fastening the back adjustment hooks in the middle row, try moving to the end, or tightest option. These small adjustments should address your concerns. If after trying both options, the bra still does not feel comfortable, it is best to discuss other options with your fitter.

  Over time your bra and prosthesis fit can be affected by weight gain and weight loss. If you feel that your bra fit is no longer comfortable or appropriate, and your prosthesis is now either too small or too large, it is time to make an appointment with your fitter. Under such circumstances, most insurance companies and Medicare will reimburse for replacement products at any time, even if you are not yet eligible for new products. Call your fitter for more information.

• Bra Care

  Pocketed bras should be cared for and laundered like any other fine washable. Wash by hand, or on delicate cycle inside a mesh lingerie bag, in cool water. Always air dry, do not put bras in the dryer, it will cause them to discolor, stretch and lose their shape.

 

Products that we offer

• Pocketed bras
• Custom Molded Breast Prostheses by Radiant Impressions
• Breast prostheses
• Partial/lumpectomy breast prostheses
• Silicone Nipples
• Lightweight fabric and foam prostheses
• Pockets that can be sewn in any bra
• Prostheses for swimming
• Pocketed lingerie
• Pocketed swimwear
• Fitting Aids to fill in gaps in bra pockets
• Compression garments
• Lymphedema sleeves
• Specially formulated skin care products for use during radiation treatments
• Non aluminum deodorants
• Hats, caps, scarves and wigs designed for hair loss during chemotherapy
• Gift Items