When Ruth Handler, creator of the Barbie doll, was diagnosed with breast cancer and underwent a mastectomy in 1970, there were very few breast forms (also known as breast prosthesis) on the shelves at the local boutiques.  This inspired her to develop a breast form that specifically fit the body which aligned with the natural slope of the breast.  She even formed her own company in 1976 to sell it.

Much has changed with breast forms since that time--not only better products, but also the wide selection to suit individuals' lives.

Women have padded their undergarments to accentuate their breasts for centuries (commonly referred to as “falsies”), using all sorts of materials.  When the bra was introduced in the U.S. in 1913, it freed women from the uncomfortable--and restrictive--corset.  During the Roaring Twenties, women used bras to flatten their breasts to match the boyish fashions of the day. The flat-chested trend reversed the following decade, when glamorous movie stars set off the "sweater girl" craze. Subsequently, Warner developed a push-up bra to create a buxom effect.

Padded bras remained popular over the next several decades, as women wanted sex appeal, until bra-burning feminists in the 1960s protested being viewed as sex objects.  Then, in the 1990s, the introduction of the Wonderbra—a sexy-looking bra with silicone pockets inside the cups--ignited sales for this product category again. Now, average-sized women could have ample cleavage for the plunging necklines that were in style.

However, nothing was available for most of the century for women who had undergone mastectomies. Most women either created their own "fake breast" from whatever soft material they had at hand, or did without. 

The introduction of the breast form allowed women to regain symmetry to their body that had been lost with a mastectomy.  Materials used for breast forms include silicone, rubber/Latex, foam or cotton batting since the goal is to imitate the shape, feel, weight and movement of a natural breast.  Mastectomy bras were also developed, containing stretch pockets on the inside to allow a breast prosthesis to be inserted and secured. 

Breast cancer patients still had little to choose from until Amoena introduced its "Affinity/Discrene" attachable systems in 1992. This was followed by Amoena's "Luxa Contact" attachable form system in 1998.

Amoena's initial forms featured one layer of material in a standard weight.  Later, the company developed a lighter weight product for specific surgery needs.  New forms also contained two layers of material--the top layer provided a natural look, while the back layer offered greater support against the chest wall.  Over the years as the company became aware of the variety of needs of breast cancer patients, it invested in research and technology to enhance designs, features and benefits of breast forms. Now, forms come in a wide range of sizes, shapes, colors and price points, along with accessories. 

Breast forms are either symmetrical (worn on either side of the body) or asymmetrical (specific to one side), and are shaped as triangles, hearts, teardrops or shells. There can also be non-attachable or attachable (by velcro or other adhesive) to provide more flexibility with a woman’s wardrobe, activities and lifestyle.

• Amoena Contact -- is for highly active women. This form feels the most like a natural breast.
• Amoena Climate - is for active women. The form "breathes" better by pulling moisture and heat away from the body.  It's comparable to wearing performance fabrics versus a knit sweater on a treadmill.
• Amoena Natura - mimics the natural breast, while contouring the landscape of the chest wall.  Made of two layers--the softer layer in front--the form's heavier back layer naturally hugs the chest wall.
• Amoena Individual - is a subset of the Natura segment.  The back layer is a moldable gel that shapes to the body.  This product fits women who have undergone a radical mastectomy with lymph nodes removed by filling in the scar tissue and laying better against the chest.
• Amoena Essential - is one layer of silicone. This basic form is standard, lightweight and less specialized, and the least expensive.

Although the array of pre-made forms meet most women's needs, some women opt for custom forms if their surgery is so exceptional that a pre-made won't fit. Custom forms, however, are considerably more costly (ranging from $3,000 to $5,000 compared to less than $500 for a pre-made form).

With 200,000 new cases of breast cancer diagnosed in the U.S. each year--most of which are in the earlier stages (0, 1 or 2)—a large portion of these women will have surgery as part of their treatment. Roughly half who have surgery will have a mastectomy (radical, modified, bilateral, partial, simple or total).  For a variety of reasons, many do not choose--or are not eligible--for breast reconstruction.  Therefore, they become candidates for a breast form.  The other half of breast cancer patients who undergo surgery will have a lumpectomy, and there are products for them as well.

To be fitted for a prosthesis, patients needs wait one to two months after surgery (and after radiation therapy, if applicable) to allow enough time for the chest wall and scar to heal, since the skin can be too sensitive. In the interim, there is a post-surgical form, which is a soft fiber-filled prosthesis that can be worn until a woman is ready to be fitted for a more natural silicone form.

"The key is getting a precise fit to the chest wall," says Beth Hohl, Breast Forms Product Manager for Amoena.

"You don't want the form to shift or fall out of the bra, but, rather, to feel part of your body," she says. "It needs to move with your body, not independently, so the form needs to hug securely. This also requires a well-fitting mastectomy bra."

Wearing a prosthesis that's too heavy can cause bra straps to dig into the shoulder--especially with larger breasted women--which can aggravate lymphedema, a swelling of the arm resulting from surgically removed lymph nodes. However, a form that's too lightweight won't work either.

"You want the right weight to replace the natural breast," says Hohl. "Otherwise, you'll be lopsided because your weight won't be distributed equally.  It's the equivalent of carrying a purse on one side of your shoulder all day long, which puts undue pressure on your back and causing your walking gait to be off. In addition, uneven weight causes neck and shoulder issues."

To achieve the correct size and weight of a prosthesis, a woman should be fitted by a  trained, certified mastectomy fitter, Hohl says.

“In addition to proper fit, women also need to consider their lifestyle needs,” she adds.
“Typically, you can find the right form in one fitting.”

Another point to note is that like undergarments, breast forms must be cleaned daily since they lay against the skin, which deposits toxins.

Partials & Symmetry Shapers
While breast forms meet the need of mastectomy patients, partial forms/symmetry shapers, also known as “partials,” are available for women who've undergone a lumpectomy.  Partials fill out the concave area where tissue has been removed to achieve a more normal-looking shape breast.

Like breast forms, partials come in a number of shapes and sizes to fit individuals.  They can be inserted inside pockets of specially made bras, or can attach directly to the chest with little pearls of adhesive, similar to the suction cups on a starfish.

And, since lumpectomy patients undergo radiation therapy, they may not realize that a radiated breast ages differently than a normal one.

"This affects the breast's density and gravity loss, so partials can even out the discrepancy between the breasts," says Hohl.

Accessories
What would a woman do without accessories to complete an outfit?  Naturally, breast forms and partials come with accessories to match lifestyle needs.  Amoena’s accessories line includes bra extenders, skin supports, back pads, climate pads, adhesive nipples, leisure forms, and swim forms (designed to be work in chlorinated and seawater), along with skincare products.

All to say, there's something for every woman who's had her breasts altered.  And that's good news.

"It's such a positive emotional 'high' to look like yourself again, to regain confidence and self-esteem," says Hohl, "Breast forms allow women to return to their normal activities and to do all the things that give them pleasure. As a result, they get their lives back."