By Grace Rush, Certified Mastectomy Fitter
The Pink Ribbon Boutique in Richmond, VA, specializes in helping individuals feel comfortable and supported after breast surgery by providing post-mastectomy bras, prostheses, and compression garments — all in a compassionate and welcoming environment.
If you’ve never visited a mastectomy boutique before, you might be wondering: What happens during a fitting? What products are available? Will insurance cover it? I’m here to walk you through what we do, how we help, and what you can expect.
Pre-Appointment
We get fitting requests either through a provider sending us a referral or by the patient calling and scheduling themselves. When you call, we collect your personal information, the name of your referring provider, and your insurance information. Once we have collected all the information from you, we can add you to our schedule. We typically schedule our appointments two weeks in advance to give your provider’s office time to obtain the necessary documentation and return it to us. Oftentimes, providers will write a prescription, but many times, there is a lot of specific information we need that isn’t included on that prescription. We send a Standard Written Order that acts as a prescription for the provider to sign and return to us with clinical documentation. The Standard Written Order we send includes everything that insurance requires, giving us better ‘firing power’ in the event of any future claim issues.
Also within that two-week timeframe, we review your insurance benefits and apply for any necessary authorizations, so you know what you’re covered for before you come in. Benefits vary from insurance to insurance, but you can usually expect to have a deductible, which is the amount you pay before your insurance starts to cover you, and a co-insurance amount, which is the percentage split between you and your insurance. You also will typically have an “out-of-pocket maximum,” which is the most you will have to pay in a benefit year. For most insurance plans, once the out-of-pocket maximum is met, you should be fully covered at 100%.
It is essential to be aware of when your insurance renews, as all accumulated amounts will reset. We strive to manage expectations and determine the best options for you. Most insurance plans should provide some degree of coverage for mastectomy bras and breast prostheses; the catch is usually the quantity they allow. If you have Medicare or Medicaid (including Advantage plans), the Women’s Health and Cancer Rights Act of 1998 mandates that post-mastectomy products have some degree of coverage.
Your Mastectomy Fitting
Our fittings usually take anywhere from 45-minutes to one hour. We first ask you to fill out an intake form. After you have filled that out, we would like to discuss your lifestyle and bra preferences. Our suggestions may vary depending on your needs, of course, and we want to ensure that we tailor your fitting experience to what will be most helpful in your day-to-day life. In the fitting room, we measure your waist, and if you’re unilateral, across the ‘apex,’ or where the remaining breast comes out the furthest. When a patient has had bilateral mastectomies, there is a bit more choice as to what size the prostheses can be.
That being said, we want to stay within a size that matches the patient’s body size range, which allows for a more ‘natural’ appearance. When a patient is unilateral, it is essential to balance the weight of the remaining breast, not only for aesthetic purposes, but also to maintain proper weight distribution across the chest. The next part of the fitting involves trying on different bras and prostheses. There is some science behind fitting, but ultimately, we are trying to find the products that make you feel like your most confident self. It can be a very daunting task to be ready for a fitting, but you have made it here, and we are so proud of you! We strive to make our store the least clinical stop on your cancer journey. Our hope is always to make patients as comfortable and safe as possible.
Brief Descriptions of the Products We Carry:
● Pocketed mastectomy bras, without underwire
● Post-surgical garments with drain management
● Compression bras for lymphedema management
● Custom 3D scanned breast prosthesis
● Silicone breast prosthesis
○ Medical grade silicone forms in varying shapes and sizes
● Non-silicone breast prostheses
○ Ex. ‘Fluffy’ Pillow-like forms, Memory foam type forms, swim forms with microbeads for water drainage
*We also carry pocketed swimwear, head coverings, port-friendly tops, robes with drain pockets, and more, which can be purchased retail (not billable to insurance).
After Your Appointment
Once your fitting is complete, we strive to have you leave with all of your products! We are fortunate to have a decent stock in store. If we don’t have a specific size, color, or other item in stock, we can usually arrange for products to be shipped directly to your home from the manufacturer. We will discuss caring for your new bras and prosthesis, and provide you with care instructions. The next time you will be able to receive new products is typically 365 days from the last time you received products. However, with Medicare, a silicone prosthesis is only allowed every two years. Additionally, if you choose to receive a reminder, we will send it to you at the beginning of the month when you are due.
That is pretty much it! We encourage all our patients to reach out at any time with questions, concerns, or for any reason.
