f you’ve lost one or both breasts to a mastectomy,
your options for managing the after-effects are
limited. Reconstructive surgery is expensive,
and women who cannot afford it or are not
offered it are left with uneven breasts or visibly
absent ones. This can devastate their sense of
femininity, and complicate something as simple
as getting dressed. Another option is to wear a
mastectomy bra or an external prosthesis, but even this can
be expensive.
Engineering technologist and tech entrepreneur Nneile
Nkholise is determined to change that, and provide breast
cancer survivors with dignity, regardless of their income
bracket. While Nneile was a Masters student working on
3D-printing prosthetic noses and ears for people with facial
deformities, she realised that the same technology could be
used to help women who had lost their breasts to cancer.
She started making prosthetic breasts that can be worn
inside a bra to create the right shape and restore symmetry
if one breast has been removed. ‘I had seen how so many
women’s lives were affected by breast cancer – and the
number of women who undergo mastectomy is at an
all-time high,’ she says.
Breast cancer is the most common cancer in women.
The Cancer Association of South Africa reports that one in
26 South African women will be affected by breast cancer
in her lifetime. However, specialist breast surgeon Professor
Justus Apffelstaedt estimates that diagnoses may be
underreported by as much as 30%, and suspects
that the real number is closer to the one in eight
reported in Britain, the USA and Australia. The
vast majority of women diagnosed with breast
cancer will have mastectomies – in the public
healthcare system it’s 75%. Justus explains that
this is because of late detection; the cancer is
already advanced by the time it is diagnosed
and it’s too late for less invasive treatments.
Waking up after a mastectomy to nothing
but bandages where your breasts used to be is
extremely traumatic for breast-cancer survivors,
and although reconstructive surgery can be
performed at the same time as the mastectomy,
this is not an option for most. The likelihood
depends largely on whether the patient is being
treated in the public or private healthcare
system. Reconstruction requires highly skilled,
specialised surgeons and many hours in the
operating theatre – both are scarce resources in
the public health system. Justus estimates that
only five to 10% of those women who havemastectomies in public hospitals will receive reconstructive
surgery. In the private sector, the rate is much higher – for
example, Justus is able to perform reconstructive surgeries
on 84% of the women who have mastectomies through his
private practice.
But for women who are not offered reconstructive
surgery, those who cannot afford it, or those who choose
not to have it, the alternative way to restore their silhouette
is by wearing prosthetic breasts. Most women who have
mastectomies opt for some kind of prosthesis – from stuffing
socks in their bras in the case of many patients in the public
health system, to sophisticated silicone prostheses for private
clients. Prosthetics can cost between R2 000 and R12 000,
with the average price hovering around R7 000 per prosthesis.
This is more affordable than surgery, yes, but still not cheap.
Nneile’s vision is to make prosthetic breasts much
more accessible and affordable, particularly in the public
sector. Today her company iMed Tech is the only one
in South Africa that uses additive manufacturing (the
technical term for 3D printing) to produce prosthetic
breasts. The social entrepreneur is working to provide
breast protheses free of charge to 1 000 women who
have survived breast cancer.
Nneile explains that the secret to affordability lies in the
mould, and this is why additive manufacturing is the perfect
technology. To create a mould for a breast prosthesis using
standard manufacturing technology costs R100 000.
To create the mould using additive manufacturing costs
R1 000 – that’s 1% of the cost. The moulds are then
filled with silicone. In total, the process takes three
days per prosthesis.
The other advantage is that, because the cost
of the mould is low, customised moulds are
easily created. ‘You can chop and change as
much as you like,’ says Nneile. iMed Tech is
working towards creating customised breast
prostheses for individual women, specific to
their breast shape, body type and preferred
style of bra. For now, the first range comes
in standard sizes and shapes, in various skin
tones (most of the other commercially available
products are for white skin). Nneile and her
team have so far completed 200 breasts.
iMed Tech sells its products too, at R800 for
standard prostheses, with higher-end versions
costing up to R1 800. The profit from the more
expensive products is used to subsidise the free
protheses. (By comparison, prostheses offered
by companies using standard manufacturing
average at R7 000 per prosthesis.)JAN/FEB 2018 MARIECLAIRE.CO.ZA 55
report
PHOTOGRAPHS
GALLO/GETTY
‘Everyone
is capable of
thinking big
and creating
noble changes’
- NNEILE NKHOLISE