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No matter what type of mastectomy you have, if you decide to remain flat, your nipples, areola, breast tissue and most of your breast skin will be removed. Your breast surgeon will leave your chest surface as smooth as possible: it may be flat or slightly concaved. Your incision(s) will run across your chest and will be red and prominent until they fade after several months.
Some women who don’t have breast reconstruction prefer to wear prostheses, breast-shaped forms that are tucked into specially made bras, camisoles, lingerie and swimsuits. (You can even find online instructions for knitting or crocheting your own soft breast forms.) Wearing a prosthesis can temporarily restore your natural shape and profile. These manmade forms are made in different shapes and sizes from a variety of materials; you can buy them with or without nipples. Adhesive nipples are also available. You can also order customized silicone prostheses, which are the most realistic (and the most expensive). Prostheses can be especially helpful after unilateral mastectomy—because one breast is missing, you may feel unbalanced and find it difficult to fit into clothes. If you decide to wear a prosthesis, it is important to consult with a qualified fitter who can help you find one (or two) that fit your chest properly.
The Women’s Health and Cancer Rights Act (1998) requires most employer and group health plans that pay for mastectomy to also pay for prostheses (with a doctor’s prescription). Most insurance companies follow Medicare coverage amounts, which includes:
Check with your insurance to determine what your policy does and does not cover.