Name of the Procedure:

External breast prosthesis garment with mastectomy form, post mastectomy (HCPCS Code: L8015)

Summary

An external breast prosthesis garment, with mastectomy form, is a specialized piece of clothing designed for women who have undergone a mastectomy (breast removal surgery). It helps in simulating the appearance of natural breasts and aids in physical and emotional recovery post-surgery.

Purpose

The primary purpose of this garment is to provide a suitable alternative to natural breast tissue following mastectomy. It addresses the physical loss of one or both breasts due to cancer or other medical conditions, aiming to restore a natural silhouette and improve the patient's body image and self-esteem. Additionally, it can prevent postural problems by maintaining symmetry.

Indications

• Patients who have undergone a mastectomy or partial mastectomy.
• Women experiencing discomfort or insecurity related to the appearance of the chest post-surgery.
• Individuals who may not be immediate candidates for reconstructive breast surgery.
• Any patient with medical contraindications to undergoing breast reconstruction.

Preparation

No special preparation is generally required for fitting an external breast prosthesis garment. However, it is advisable for patients to:

• Schedule a fitting appointment with a certified mastectomy fitter.
• Wear a comfortable, non-bulky top to the fitting session.
• If currently undergoing chemotherapy or radiation therapy, consult with their oncologist for any special considerations.

Procedure Description

1. Initial Consultation: Meet with a certified mastectomy fitter to discuss needs and preferences.
2. Measurement and Fitting: The fitter takes detailed chest measurements to ensure correct sizing.
3. Selection: Patients try on several prostheses to choose the most comfortable and natural-looking option. Varieties include silicone forms, foam forms, and other lightweight materials.
4. Customization: Some garments allow for customization to ensure an appropriate fit.
5. Education: Patients receive instructions on how to wear, clean, and care for the prosthesis garment.

Duration

The entire fitting and selection process typically takes about 1-2 hours.

Setting

Performed in an outpatient setting such as a specialty lingerie store, a mastectomy boutique, or a hospital fitting room.

Personnel

• Certified mastectomy fitter
• Occasionally, a nurse or other healthcare provider may be involved in the fitting process.

Risks and Complications

Risks associated with external breast prosthesis garments are minimal but may include:

• Skin irritation or allergic reaction to the materials used.
• Improper fit, causing discomfort or postural imbalances.
• Psychological discomfort if the appearance is not as expected.

Benefits

• Immediate improvement in body contour and symmetry.
• Mental and emotional uplift due to restored body image.
• Non-invasive and customizable to individual needs.
• Helps prevent postural and spinal issues due to uneven weight distribution.

Recovery

There is no formal recovery period for using an external breast prosthesis garment. Patients should:

• Follow care instructions for the prosthesis and garment.
• Regularly check for signs of wear and replace the prosthesis as needed.
• Schedule follow-up fittings if there are changes in weight or after further surgical procedures.

Alternatives

• Reconstructive Breast Surgery: A more permanent solution involving surgical intervention. Pros include permanent results; cons include surgical risks and longer recovery.
• Going Without a Prosthesis: Some patients may choose not to use a prosthesis for personal comfort. However, this may result in postural problems or uneven appearance.
• Internal Prosthesis (Implants): Surgical option with its own set of benefits and risks similar to reconstructive surgery.

Patient Experience

Patients typically experience initial relief and satisfaction with the enhancement in appearance. Some may feel slight discomfort during the initial adjustment period, but proper fitting usually alleviates this. Emotional support and counseling may be helpful for managing the psychological impacts of mastectomy and adapting to the prosthesis. Pain is generally not associated with the use of an external prosthesis, but comfort measures include wearing looser clothing initially and gradually getting accustomed to the device.