Making the Breast of a Bad Situation


Farrell Friedenberg wants to help women who have had mastectomies, lumpectomies or reconstruction surgeries feel “whole” again.

Women who have battled breast cancer — the most common cancer among American women apart from skin cancer, according to the American Cancer Society — can now go to Jay Ann Intimates where they can get scanned for a custom fit prosthesis; it’s the first boutique to have its own scanner and offer this service to women in the area. They also have a boutique at the Fox Chase Cancer Center in Northeast Philly.

“It’s a very important part of what we do,” said Friedenberg, the third-generation owner of the Huntingdon Valley boutique. “We want to make someone whole, whether they’ve had
mastectomies, partial mastectomies, even if it was years ago.”

A wall of the back room of the store is stacked with pink boxes labeled with a variety of sizes and colors that hold a zippered pouch with a prosthesis. There are two main types of prostheses, depending on what the woman wants, said Friedenberg.

The standard prosthesis, which comes in a variety of skin tones and numbered sizes instead of cup sizes, runs about $325 and would fit any woman for the most part. It’s a little heavy, so it provides weight for the woman when it’s placed in a bra.

The custom prosthesis, however, is lighter and its shape is totally unique to each woman.

“Say somebody had a failed reconstruction and they had excess skin on their chest wall and they want something more contoured to their actual surgical site. This was someone’s chest wall that was really uneven,” Friedenberg said, holding an example of a custom prosthesis. It does not have a flat back but instead has ripples that would fit exactly to the particular woman’s chest wall.

“It works like a puzzle. For the majority of the women, this is perfect,” she said, adding they can customize the skin tone or the areola size or whether or not the woman wants a nipple, and if they do, do they want a raised nipple. “You’re trying to make someone exactly how they were.”

Friedenberg and Jay Ann associate Susan Stanton flew to Marietta, Ga., in the spring to train at the headquarters of breast care company American Breast Care, who asked them if they wanted to have their own scanner in the store. Previously, they had worked with a different company that sent a representative each time a woman wanted to be scanned for a custom prosthesis. Now, working with American Breast Care, Stanton can use the scanner in the store on the spot if a woman expresses interest.

The custom prosthesis runs about $3,000 per breast, but in many instances, insurance will cover the cost. The insurance is the most challenging piece, Friedenberg said — many women don’t know what they’re covered for. Surgical bras, for example, have pockets on the sides where the prosthesis can fit and are typically billable to insurance. Not all women know that, she said.

Friedenberg tries to make the process as painless as possible with insurance.

“If it’s her first fitting, someone can be upset,” she said. It’s a big surgery. You don’t want to then say, ‘Here’s the receipt, figure it out with the insurance.’ We try to do as much hand-holding as we can possibly do.”

Not every type of insurance covers the custom prosthesis. Medicare, for example, does not. But that’s one part that Friedenberg has really tried to grow
because it’s something she and the other associate feel passionately about.

“We’ve grown that side of the business because it’s something very important,” she said. “When someone comes in and they’re just despondent that they’ve had this major surgery and it’s a life-altering event and they don’t know what to do, we try to really ease their fears.”

This technology is important because even though products for breast cancer care have been around since the 1970s, no one really talked about it like this, Friedenberg said. While in the past, women would have to use socks or some other kind of filler in their bra following a surgery, now they have more options.

Stanton loves being able to use the scanner, which she helped with when they worked with the previous company. It fits into a simple black case like a little suitcase that Stanton cares for like it’s her baby, she said with a laugh.

“If someone comes in and they express interest in this and we verify their insurance, I could do it for them on the spot if we have enough time,” she said.

There are two to three scans Stanton does for each woman, including with a bra, without a bra and with a prosthesis, all in order to get an idea of the woman’s shape. She puts sensors on the woman’s chest wall to help the scanner pick up imaging, which creates a three-dimensional model of her chest.

These images are sent to Georgia, where engineers work on the custom prosthesis. It takes four to six weeks to get the scans back, she said, and then they do a design review to make sure it’s what the woman wants.

The challenge comes with what type of surgery the woman had and what she wants to look like, especially if it was a lumpectomy or a partial mastectomy.

“I have some women that want [the prosthesis] really projected. This is sort of a challenge because you have to match this remaining side,” she explained. “When it’s a bilateral mastectomy, you can be whatever you want. This one woman wants really large breasts because that’s what she had before her surgery and that’s what makes her feel normal. You customize it to what the patient wants.”
The technology of the scans is Stanton’s favorite part and being able to help a woman with the process when it’s something she wants.

“When I found out we were going to have our own, I was super-excited,” she said. “I like the motion of doing it — I think it’s an interesting option for people and it’s different. Especially for a woman that has an active lifestyle or they’re younger or they just want to be more comfortable, being able to help in the process of doing something like that for them is really nice.”

Sometimes, coming in for a bra fitting and a prosthesis is an emotional experience. But it depends on the woman, Stanton said.

The custom prosthesis is a personal choice and isn’t for every woman — sometimes many women feel like nothing will replace the body part that’s missing. But if it is the right option, it’s one way of making that woman’s life easier.

“It’s funny, because everyone is so different. Most women I interact with are not super-emotional about it,” Stanton observed. “They’ve kind of accepted it, and there are some other women who are like, it’s never going to be their breast, it’s always going to be a prosthetic. There’s only so much you can do to satisfy someone’s expectations,” she said. “We try to do the best we can.”

“A lot of the women I see are inspiring and strong and are like, ‘Whatever, I don’t have a boob. It’s not the end of the world.’ This is just something to make their life a little bit easier.”

She’s happy companies are coming out with technology like this as women’s issues often get “pushed to the side.”

For Friedenberg, seeing a woman with a prosthesis that makes her feel like her old self is the best part of the job.

“When someone who comes in who just doesn’t know how to move on, and it’s incomprehensible after surgery what they’re going to do, and you put them back together — someone who was just so upset coming in is like, ‘This is exactly what I used to look like’ — you’ve done your job, you’ve done it. It’s the best feeling.”

Contact: [email protected]; 215-832-0740


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