Frequently Asked Questions

Q. Isn't this service considered cosmetic? Will my insurance cover this procedure? How much and when do I have to pay?
A. These services are not cosmetic, but reconstructive. Hence, they are medically necessary, and should be covered by your insurance. Click here for more info

Q. How do I care for my artificial eye?
A. General care instructions... Click here for more info

Q. What are my options as a breast cancer survivor?
A. Reconstructive options for breast cancer survivors... Click here for more info

Q. Will Medicare pay for my breast prosthesis?
A. Yes and No. Click here for more info

Q. How do I make an appointment?
A. Click here for more info

Q. What to expect for your custom breast prosthesis casting appointment.
A. Before your Custom Breast Prosthesis casting appointment... Click here for more info

Q. How do I order more adhesive for my prosthesis?
A. Type of adhesives & how to order. Click here for more info

Q. How do I care for and apply my prosthesis when using adhesives?
A. Daily care & restoration of prosthesis. Click here for more info

Q. How is the Radiant Impressions (RI) Breast Prosthesis different from other brands?
A. Most external breast prostheses are filled with a silicone gel... Click here for more info

• Kaiser
• TriCare / Tri West
• Colorado Access
• Medicaid
• Medicare (with the exception of custom breast prosthesis –
  they only allow for the non-custom)
• Great West
• Total Long Term Care
• Rocky Mountain HMO / Rocky Mountain Health Plan
• Blue Cross Blue Shield (non-custom and custom breast prosthesis only)
• VA

Q. How do I care for my artificial eye?
A. General care instructions:

• For cleaning: Rinse eye and socket with Normal Saline Solution (eye wash) twice daily, without removing the prosthesis*. This can be accomplished by partially filling an eyecup, holding this against your socket, then tip head back while moving your eye back and forth. Some patients prefer to just "squirt" the socket directly from the bottle. Many bottles come with a nipple-type top, which makes it fairly convenient to direct the stream of saline. Rarely should the eye be removed to clean the socket - however, exceptions do occur. If you have a cold or allergies, you may need to increase the number of times you clean your eye per day.
  
  Saline Solution can be purchased anywhere contact lens products are sold.
  
  
• For lubrication: For the average artificial eye wearer, Safflower Oil** has been found to be an excellent lubrication for the socket (it does not thicken in cold weather). Start with one drop as needed. Some prefer to just use this oil at night around the eyelids to prevent normal nighttime secretions from becoming overly dry; instead, the oil softens the secretion which lessens the amount of "scratching" damage done to the eye in the morning due to dried up drainage. Safflower Oil may be purchased at any grocery store - use the bottle for cooking, reserving a little for your eye. (RMA will provide you with a bottle for this application.)
  
  A second lubrication choice, generally found at health food stores, is Coconut Oil. Again, it is not necessary to remove the artificial eye to apply the lubrication.
  
  Another lubrication choice is Refresh PM (available generically). This is an over-the-counter lubricant, which has been highly recommended by my patients. It looks like Vaseline, only it "melts" quicker. Other Refresh Brand products to try are Refresh Liquigel and Refresh Endura.
  
  For those patients needing a heavier lubricant, a silicone oil may be purchased from Factor II at 1-800-332-8688 - specify light (medium, heavy, and extra heavy are also available). Factor II also has their own brand in light, heavy, or extra heavy. Note: the silicone oil may interfere with medicinal drops being used - you may need to discontinue or delay use while using the medication.
  
  
• A professional polishing: A professional polishing is recommended at least once a year.
  
  *For those patients wearing a "shell eye" (one that fits over an existing eye), removal of the prosthesis at night may be necessary.

**Reference: Guibor & Gougelmann (eds.): Problems and Treatment of Enucleation, Eviseration, Exposure, vol. 2, p. 239: The Dry Socket - A New Lubricant, Noble, Hill & Webb. Stratton Intercontinental Medical Book Corporation, 381 Park Ave. South, NY, NY 10016.

QUESTIONS? Call 303.973.8482.

Typical surgical conditions and recommendations:

• Superior Sulcus Deformity
• Ptosis of the upper lid
• Ptosis of the lower lid
• Implant replacement
• Other______________________________

• Pain
• Risk of complications
• Risk of infections
• Side effects
• Death
• $30-40,000.00
• Surgical updates every ten years (more of the above)
• Final result is patient's own body tissue

Custom made prosthesis:

• Non-invasive procedure
• Custom fit around contours of irregular tissue mounds - this allows for complete freedom of movement for normal activities
• The Radiant Impressions™ prosthesis can be worn with or without a special mastectomy bra
• The Radiant Impressions™ prosthesis is 50% lighter than other products on the market - which is beneficial to balance and back pain
• The Radiant Impressions™ prosthesis is made from a new silicone foam that does not leak, maintains a cooler and more comfortable temperature, and is breathable
• The Radiant Impressions™ prosthesis is more durable than most other products on the market (i.e., can be worn in chlorinated water; punctures do not destroy the product)
• The Radiant Impressions™ prosthesis can be worn in direct contact with the skin with or without adhesive, with no adverse reactions
• The mirror image (shape and color) that is created is beneficial psychologically
• Cost of the Radiant Impressions™ custom and non-custom prostheses are within Medicare "allowable" rate. Please call for details at 303.973.8482.

**Some people mistakenly confuse the terms "non-custom" and "custom." A non-custom product is designed as an interim product to be used while a woman is healing, yet is sometimes used longer when a woman has no insurance, or thinks she has no insurance coverage, or when the custom product costs over and above what her insurance coverage allows. Non-custom prostheses are very limiting and cumbersome for most patients.

Q. Will Medicare pay for my breast prosthesis?
A. Yes, most insurance companies pay 80% for the Radiant Impressions prosthesis. Some companies are more difficult than others. We are currently in negotiation with them. For more specific updates, please call our office. The amount paid by insurance is always subject to individual plans as well as deductible and co-pay amounts.

Medicare
The non-custom is easily billed and paid for. The custom is currently not paid for by Medicare, but we are working on changing the system and are very hopeful this will be accomplished in the near future.

Visa and MasterCard accepted.
Care Credut.
Payment plans available.

Q. How do I make an appointment?
A. To make an appointment please call our office at 303.973.8482 or email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it. . Please note that pre-authorization from the insurance company needs to be obtained before an appointment can be confirmed. Our offices will do all the leg work necessary in obtaining the pre-authorization upon your request for an appointment. When calling to make an appointment please have the following information available:

1. Patient Information
   Name
   Address
   Phone number
   Date of Birth
2. Insurance information
   Primary & secondary Insurance information
   Patient ID#
   Group #
   Insurance phone number (located on the back of your insurance card)
3. Referring doctor information
   Name
   Phone number
   Address
4. Primary Care Physician – if your primary care physician is different from your referring doctor we will need their information as well (many insurance companies require a PCP in order to authorize services)
   Name
   Phone number
   Address

* Once pre-authorization has been received your appointment will be confirmed.

Q. What to expect for your custom breast prosthesis casting appointment.
A. Before your custom breast prosthesis casting appointment...

What to bring:

• Bra * (please see below for details)
• Insurance card
• A friend if you would like

What to wear:

• Comfortable shoes
• Older clothes that you don’t mind getting a little dirty. The casting materials may get on your clothes during the process

What to eat / drink:

• Eat a full meal within 2 hours of your appointment
• Drink plenty of water the night before and the day of your casting (bathroom breaks will be available before and after each casting as needed).

What to expect:

• First appointment lasts approximately 2 hours. During that time you will have 1-2 castings each taking between 15-20 minutes.
• Water soluble markers will be used to draw diagrams on your chest followed by plaster casting material applied to the same area (including your bra). The material goes on wet but dries fairly quickly.
• You will be standing during the casting
• The second appointment lasts about 1 hour. During this time, highlight colors are applied to the nipple area on the prosthesis and instructions are given regarding the application of the adhesive and general care of the prosthesis.
• Once the casting has been completed it may take up to 8 weeks for the prosthesis to come in from Radiant Impressions. Upon receiving the prosthesis at our office we will call and schedule a time for you to come in for the second appointment. The second appointment will be scheduled as soon as possible upon receiving the prosthesis, usually within a week.

* If you normally wear a bra, bring along a bra of a style you intend to wear on a regular basis in good condition. We will need to keep this bra for the duration of the manufacturing process. Usually, it comes back intact (but this is not guaranteed).

If you choose a bra that opens in the front, please be aware that it will need to be cut in the back after the casting process. Also, be sure to choose a style that does not have too deep of a v-cut in the front.

Feel free to bring in several styles of bras if you are not sure of the look you want (leave the price tags on if you need to return them after choosing the best style for you).

Q. How do I order more adhesive for my prosthesis?
A. To order adhesives call Factor II, Inc. T 1.800.332.8688 or online at www.factor2.com.

Pros Aide (Water Based) Adhesive
This adhesive was developed for facial prostheses. It is to be applied and allowed to air day until adhesive turns from its natural milk color to a transparent color. It takes about five minutes for this process to occur. This material will roll off the prosthesis. Afterwards be sure to clean with soap and water. (Contains a honeysuckle scent and some patients may have skin reaction due to added scent.)

Daro Hydro Bond
This is the strongest Daro product to date. Has least amount of water and most solids.

Secure Adhesive (Silicone Base) Solvent: Ethyl Acetate)
Since most prostheses are made of silicone, Secure Adhesive was specifically designed as a silicone adhesive. Therefore, use this adhesive sparingly. Apply a thin layer of adhesive to the margins of your prosthesis. Allow to air dry for three to five minutes. Apply to your skin with firm, even pressure. To remove the adhesive from your prosthesis, a solvent is required. We recommend that you try to use the Lan-O-Solve(B-301) first. This will be sufficient in most applications. If this does not remove the adhesive from your prosthesis completely, then use the Medical Adhesive Solvent (B-508).

Adhere Medical Adhesive
Pressure sensitive medical silicone adhesive.  Retains adhesive qualities in the presence of moisture or perspiration.  Adhesive qualities are unaffected by normal temperature variations (similar to Secure brand listed above).

Helpful Hints:
When extra adhesion is needed, layer the adhesive as follows:

1. Apply one layer of Pros Aide (or Daro) to prosthesis and let dry until clear.
2. Apply second layer of Pros Aide (or Daro) to prosthesis and let dry until clear.
3. Apply a layer of Secure to prosthesis and let dry for approximately 3 minutes.
4. Apply prosthesis in place on skin.

When removing the prosthesis, clean only what is dirty and leave the remaining layer. Only remove all the adhesive layers after 2-4 days of accumulation. It will then roll off like rubber cement. To apply new adhesive repeat the gluing process (see” helpful hints”).

Q. How do I care for and apply my prosthesis when using adhesives?
A. Daily Care & Restoration of Your Prostheses*

Preparing Your Skin and Your Prosthesis

1. Repeatedly practice positioning your prosthesis without adhesive to ensure accurate placement.
2. Wash and thoroughly dry your hands and skin where your prosthesis is to be placed.
3. Clean your prosthesis with a soft, bristled toothbrush, mild soap, (i.e. Ivory liquid) and warm water.

Applying Your Prosthesis

1. If adhesive is used, it should be applied with a cotton tipped swab by evenly spreading a thin layer of the adhesive along the outer edges of the back side of your prosthesis according to the manufacturer’s instructions.
2. Allow the adhesive to reach its proper pre-application state depending on the type of adhesive used (i.e. dried clear Pros-Aide / Daro).
3. Using a mirror, carefully position and press your prosthesis onto your skin to ensure good contact.
   *** Keep from freezing all water based adhesives!

Removing Your Prosthesis

1. Remove your prosthesis from your skin on a daily basis to keep your tissues healthy and to maintain hygiene. Grasp the thickest edge of your prosthesis and gently remove it very slowly so as not to tear the edges or irritate your skin.
2. If necessary, use a moist washcloth over the surface of the prosthesis to loosen adhesive from your skin.

Cleaning Your Prosthesis

1. If adhesive was used, remove it by gently rolling the adhesive off the prosthesis (starting from the center to the outer edges) with your fingertips, using gauze or textured cloth. Soaking the prosthesis in a cup of warm water helps to soften adhesive and make it easier to remove.
2. Clean the prosthesis with a soft, bristled toothbrush, mild soap (i.e. Ivory soap), and warm water. Avoid using soaps with lotions or moisturizers. Also avoid using solvents to clean your prosthesis.
3. Remove any traces of adhesive or oil by gently wiping the tissue side with a gauze or soft-textured cloth moistened with rubbing alcohol. Repeat this step using a gauze or soft-textured cloth moistened with Listerine on the back side of the prosthesis.
4. If your prosthesis has an ocular component, remove and clean it with soap and water. The ocular component should not be cleaned with rubbing alcohol. Place a drop of mineral oil on the eye and shine the eye once a week.
5. If your prosthesis is retained with magnets, clips, or plastic buttons, take care to clean around each fixture with a soft, bristled toothbrush, soap, and water.

Cleaning Your Skin

1. Wash your skin with soap and water after removing the prosthesis and remove any residue of adhesive with a soft textured cloth.
2. Avoid the use of harsh solvents such as benzene or xylene. Mineral oil (baby oil) is suggested for removal from the skin.
3. Apply a moisturizing lotion on a nightly basis to restore natural body oils.
4. Report any areas of inflammation or irritation to the office or clinic.

Color Changes

1. Avoid smoking as it will stain and yellow the prosthesis.
2. Avoid prolonged exposure to sunlight, which can cause fading of the color of the prosthesis.
3. Avoid the use of strong solvents, such as benzene and xylene, which can cause color dissolution and weakening of the prosthetic material.

Storing The Prosthesis

1. Store the prosthesis in a dry, inconspicuous but safe place (for example, a bedside table drawer).
2. Keep out of reach of children and animals.
3. If you have an orbital prosthesis, store in an upright position.

Preventing Mishaps

1. Avoid extreme temperature changes, which can cause adhesive to fail.
2. Carry extra adhesive and prepackaged alcohol-soaked cotton balls in a small plastic bag.
3. Avoid placing the prosthesis in purses or pockets close to items such as ink pens and makeup that could stain it.
4. If adhesives are prescribed, be careful not to spill the adhesive from the bottle. To prevent evaporation, keep the lid tightened when not in use. To increase the life of your adhesive add a small marble or steel ball to lessen the amount of air in the bottle and keep it fuller.

*Information courtesy of ABI Professional Publications. McKinstry, Robert E. and Habakuk, Susan W., “Daily Care of Your Facial Prosthesis”. Fundamentals of Facial Prosthesis’ pg. 198.