In order to obtain accurate measurements, the ideal time to conduct a fitting is 6-8 weeks after surgery. At such time, the fitter will ensure incisions are dry and healed and swelling is at minimal. The client should be able to stand small degree of compression around chest and underarm areas as bra needs to be tight fit (loose fitting bra will adversely affect prosthesis fitting).
A good fitted bra is the most important component to a successful mastectomy fitting. Hence bra fitting will be the first step. A good fitted bra should be a well structured pocketed bra with soft cups, seamed and non-wired. Based on the surgery, there are 3 main groups of clients that require different fitting approaches:
- Uni-lateral mastectomy surgery (one breast is removed)
- Bi-lateral mastectomy surgery (both breasts are removed)
- Reconstruction after mastectomy surgery
Two measurements are needed to determine bra size: under-bust measurement and over-bust measurement.
For uni-lateral client, measurement is taken on the non-mastectomy side (natural breast side). The client will be required to wear a bra (own used bra is okay to support natural breast). Measure from the sternum to the spine (1/2 of the torso) horizontally under the bust making sure no breast tissue is included in the reading. Use the number to multiply by 2 and add four inches, formula should be : (number x 2) + 4 = band size. The next will be measurement for cup size, measure from the sternum to the spine over the fullest part of this side if the torso. The difference of the 2 numbers tells the cup size, if the number is less than 1 (AA cup); if the number is between 1 to 1.5 (A cup); about 2 (B cup); between 2 to 3 (C cup)
For bi-lateral, client can go by with the same bra size as before surgery if they want to maintain the same size. However, mastectomy bras do fit differently from regular sized bras. The easiest way to determine the band size is to measure client the same way as an uni-lateral.
After the natural breast is fitted in a pocketed structured bra, the next step is fitting for appropriate prosthesis (or 2 prostheses). The objective is to find the best matching form to mimic the natural breast to accomplish balance ( in terms of projection and weight).
Different suppliers, namely Amoena and Anita, offer a variety of breast forms in different shapes and weights. Depending on how radical the surgery is, breast forms come in 2 main categories: symmetrical (can be used on either left or right side) and asymmetrical (side specific for left breast/right breast).
For reconstruction after mastectomy clients, a post surgical front closing compression bra is required. Fitting of this type is totally different from pocketed bras with silicon prosthesis. Depending on the type of reconstruction, cup size differs. One rule of thumb is loose fit for the cup size and comfort fit for the band size. If further compression is needed, a compression can always be added.