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916 First Form Breast Prosthesis Foam Leisure Form | Blush Bring It Up This daring look in BalletThe American Breast Care First Form Breast Prosthesis Foam Leisure Form in Blush is designed to provide natural shape and a secure fit. This memory foam prosthesis contours to your body's curves to deliver comfort and a realistic look. Ideal for post surgical or leisure wear with your favorite pocketed mastectomy bra, this prosthesis is perfect for those who have undergone a simple or modified radical mastectomy. HCPCS L8020: Breast Prosthesis,