[1615]

Suggested HCPCS: L8030

Reflection® Triform™ External Silicone Breast Form. This triangle-shaped form is suggested for less radical surgeries when underarm tissue loss is not a factor. Adaptable right or left. Sizes 1 through 14.

Cup
Size
Bra Size
30323436384042444648
AA12, 3456789----
A14567891011--
B--55, 678910111213
C--67891011121314
D--7891011121314 --
DD----91011121314 -- --
F------11121314 -- -- --
G------121314 -- -- ----
GG------1314 -- -- ------
HH------14 -- -- --------

NOTE: This fitting chart is intended as a general guide only. Some fittings may differ from
the suggested chart size depending on the extent and the type of brassiere worn.

Available Options:

Size:

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