A breast prosthesis is an external, wearable form — usually silicone — designed to sit inside a bra or be attached to the chest wall, recreating the shape of a breast that has been removed by mastectomy. It is an alternative to surgical breast reconstruction and is used by many women either as a long-term choice or as a temporary measure between mastectomy and a later reconstruction.
A prosthesis is a non-surgical option after mastectomy. It is not the same as an implant (which is surgically placed inside the body) or as autologous reconstruction (which uses the patient’s own tissue). It is removable, requires no further surgery, can be replaced as the patient’s body changes, and is fully funded by the NHS for women who have had mastectomy. Modern prostheses are made to closely match the natural breast in shape, weight, and movement.
Orientation Why you might be reading about this
You may be deciding between reconstruction and a prosthesis after mastectomy, or thinking about the in-between option of using a prosthesis now and considering reconstruction later. Both are legitimate routes — the choice is personal, and many women change their mind in either direction over time. This page explains what a prosthesis is, what it does well, what its limitations are, and how it sits alongside the reconstruction options.
Related terms: Mastectomy · Breast reconstruction · Aesthetic flat closure · Delayed reconstruction
Definition What a prosthesis is, in practice
The standard modern breast prosthesis is a silicone gel form, weighted to feel similar to natural breast tissue, with a skin-coloured outer layer. It comes in a range of shapes and sizes to match different breast shapes and bra cup sizes. The most common type sits inside a specially-designed pocket bra (a mastectomy bra), which holds it securely against the chest wall.
Variants include:
- Lightweight foam or fibre-fill prostheses — used in the first weeks after mastectomy while the surgical site heals and a fitted silicone form would be uncomfortable. Often called a softie.
- Silicone gel prostheses — the standard long-term form. Fitted by a specialist appliance officer who measures and matches to the contralateral breast.
- Self-adhesive / stick-on prostheses — attach directly to the chest wall using a medical-grade adhesive backing, allowing wear without a pocket bra. Useful for swimwear, active wear, or low-cut clothing.
- Partial prostheses (shells) — sit over a breast that has had a partial mastectomy or significant volume change, restoring symmetry rather than replacing the whole breast.
The procedure How a prosthesis is fitted on the NHS
NHS-funded fitting follows a defined pathway:
- Initial soft form — provided in hospital after the mastectomy, before discharge. Most patients receive a softie at this point and wear it for the first few weeks while the chest wall heals.
- Specialist fitting appointment — usually 6 to 8 weeks after surgery1, once the wound has healed and any swelling has settled. The fitting is done by an appliance officer or breast care nurse trained in prosthesis fitting, often at the local hospital’s mastectomy / breast care service3.
- Choice of form — the fitter offers a range of shapes, sizes, and styles, with the patient trying them on with their own clothing. The aim is a match to the contralateral breast in volume, projection, and weight3.
- Pocket bras and swimwear — provided alongside the prosthesis. The NHS provides the prosthesis and pockets for bras and/or swimwear (provision varies by trust); dedicated swim prostheses and mastectomy swimsuits are usually self-funded1.
- Replacement schedule — typically every 2 years1, or sooner if the prosthesis is damaged or no longer fits well (after weight change, contralateral surgery, etc.). Replacements are funded.
A specialist boutique service (private — paid out of pocket or through some insurance plans) can offer a wider choice of forms, more styles of mastectomy bra, lingerie, and swimwear, and dedicated fitting time. Some patients prefer the NHS service; others prefer a private fitting alongside their NHS provision.
Comparison Prosthesis vs reconstruction — the practical comparison
| Factor | External prosthesis | Surgical reconstruction |
|---|---|---|
| Surgery required | None — fitted externally | Yes — additional operation(s) |
| Recovery | None beyond the mastectomy | Weeks to months on top of mastectomy recovery |
| Cost (NHS) | Free, replaced every ~2 years | Free (immediate or delayed) |
| Permanence | Removable; can switch to reconstruction later | Permanent (though revisions possible) |
| Feel during the day | Worn in bra; some patients describe a sense of “carrying” the prosthesis | Part of the body; no sense of an external object |
| Lifestyle adjustments | Bra always required for symmetry; specific swimwear and active wear | None after recovery |
| Sensation | Chest-wall sensation only | Often reduced; varies by reconstruction type |
| Body image | Body symmetrical when dressed; asymmetry visible undressed | Symmetrical clothed and undressed |
| Risk of further surgery | None | Usual surgical risks; revision possible |
There is no “right answer.” Some patients are content with a prosthesis indefinitely; others find that even a well-fitted prosthesis is a daily reminder they would rather not have, and choose reconstruction (immediate or delayed). Many women try a prosthesis first and consider reconstruction later when they have had more time to think — this is a perfectly reasonable pathway.
Who chooses it Who tends to choose a prosthesis?
Common reasons given:
- Avoiding further surgery — particularly if cancer treatment has been demanding, the appeal of being “done with operations” is real.
- Health factors that make reconstruction higher-risk — significant comorbidities, smoking, diabetes, very high BMI in some autologous reconstructions.
- Logistical factors — work, caring responsibilities, or simply the wish to return to normal life as quickly as possible.
- Lifestyle preference — some patients are content with their body shape clothed and prefer to remain flat undressed (an option the patient can also support with aesthetic flat closure, which is a closely-related but distinct decision).
- Wanting more time to decide — a prosthesis allows the decision about reconstruction to be deferred indefinitely without committing to either path.
Comparison Aesthetic flat closure vs prosthesis vs reconstruction
These three options are related but distinct:
- Aesthetic flat closure is a surgical decision at the time of (or after) mastectomy to close the chest wall in a smooth, deliberately flat contour with no reconstruction planned2. It does not preclude later use of a prosthesis if the patient wants to wear one some of the time, and it does not preclude later reconstruction if the patient changes her mind. See aesthetic flat closure.
- Prosthesis use is an external choice that can sit on top of any chest wall outcome — patients with reconstructed, flat-closure, or default-closure mastectomies all have the option to use a prosthesis when they want to.
- Reconstruction is the surgical option to rebuild the breast.
The decision pathway is: first, what kind of mastectomy and what kind of chest-wall closure (default, aesthetic flat); second, whether to reconstruct (immediately, delayed, or not); and third, whether to use a prosthesis at any of those stages.
At consultation What to discuss with your surgeon and breast care nurse
- What kind of mastectomy chest-wall closure is being planned — and is aesthetic flat closure being offered as an option if reconstruction is not wanted?
- What does the NHS prosthesis service look like at your hospital — when is the first fitting, what is offered, and who runs the service?
- Where can you go for a private fitting if you would prefer a wider choice or more time?
- If you choose a prosthesis now, can you reconsider reconstruction later — and what would the timeline and surgical options look like at that point?
- Are there support groups of women who have chosen a prosthesis route, and would meeting them be helpful before deciding?
If you are still weighing reconstruction versus a prosthesis, the reconstruction pages and fees and insurance set out the surgical and funding options.
Resources Further reading
- Breast Cancer Now — Breast prostheses — patient information on prostheses and the fitting service.
- Macmillan Cancer Support — Breast prostheses — practical guide and lifestyle advice.
- Breastory: Mastectomy · Breast reconstruction · Aesthetic flat closure · Survivorship hub