Understanding Nipple Prosthetics and Insurance Coverage After Mastectomy

What Are Nipple Prosthetics?

Nipple prosthetics are realistic, reusable silicone nipples designed to mimic the shape, color, and texture of a natural nipple and areola. They’re ideal for anyone who chooses not to undergo additional surgery or who simply wants a non-invasive, customizable option.

Each prosthetic is made from medical-grade silicone that moves naturally with the skin. Some clients select from prefabricated shapes, while others choose fully custom prosthetics that match their original anatomy or their other breast.

How They’re Created & Why Casting Before Surgery Matters

If you’re preparing for a mastectomy, you can actually have your nipples cast before surgery. This process captures the exact shape, size, and projection of your natural nipples so they can be replicated later as prosthetics.

A mold is created using skin-safe material in a clean environment, and that mold becomes the template for your silicone prosthetic after your reconstruction or flat closure has healed.

If you’ve already had surgery, your prosthetic can still be custom designed from photos or by matching your reconstructed shape.

Pairing a prosthetic with a hyper-realistic areola tattoo gives the illusion of a natural nipple complex, combining 3-D projection with soft, believable pigmentation, an option many clients prefer to additional surgery.

Insurance Requirements After Mastectomy

Under The Women’s Health and Cancer Rights Act (WHCRA) of 1998, any insurance plan that covers mastectomy procedures must also cover all stages of breast reconstruction. This includes:

- Reconstruction of the breast where the mastectomy was performed

- Surgery on the opposite breast for symmetry

- Prostheses (including nipple prosthetics)

- Treatment of any physical complications related to the mastectomy

That means if your insurance covered your mastectomy, it is federally required to cover reconstructive options — whether that’s surgical nipple reconstruction, tattooing, or a prosthetic nipple.

Some insurers list nipple prostheses under codes L8032 (prefabricated) and L8033 (custom fabricated). Tattooing often falls under CPT 11920–11922 when billed as part of medical reconstruction.

Coverage can vary by state and policy, so a prescription or letter of medical necessity from your doctor is helpful. In West Virginia, certain plans still classify tattooing as cosmetic, but prosthetics are increasingly recognized as “medically necessary” under federal law.

How Artists and Providers Fit In

As a medical tattoo artist, I often coordinate with surgeons and oncology teams to make the reconstruction process smoother.

For survivors who choose a prosthetic instead of surgical reconstruction, I can help:

- Arrange or refer for nipple casting prior to mastectomy

- Color-match prosthetics with custom areola tattooing for symmetry

- Provide documentation and itemized invoices with correct billing codes

- Connect clients to grant funding or nonprofit resources if insurance denies coverage

Why This Matters

Restoring the nipple-areola complex isn’t just cosmetic, it’s about closure. It’s the emotional and visual completion of reconstruction, helping survivors feel whole again.

Whether you choose tattooing, a prosthetic, or both, you deserve access to care that respects your healing process and that includes fair insurance coverage.

If you’re preparing for surgery or exploring your post-reconstruction options, reach out to discuss pre-mastectomy nipple casting, custom prosthetics, or areola tattooing.

At Alchemy WV, we’re committed to helping survivors across West Virginia rebuild their confidence, one beautiful detail at a time.