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A re-usable and self-adhering prosthetic nipple - so you're whole again

ORDER FORM

Order Form

ReForma is advanced prosthetic nipple with a patent pending, self-adhering silicone backing · Customized coloring · Life-like suppleness · Thin-skin design · Durable · Re-usable · Washable · Waterproof · No glues · Made in the USA.

Sold in pairs.

If you have a discount code or Physician Office Code discount,
you will be asked for it AFTER you hit the 'Checkout' button.

Enter a quantity for each item you would like to add to your shopping cart then click the 'Add To Cart' button at the bottom of the listing to proceed. If you have a discount code or Physician Office Code discount, you will be asked for it AFTER you hit the 'Checkout' button.

Quantity	Image	Item
Quantity		Medium-Colored Nipples, Size: 2.25" Diameter "The original ReForma Nipple" This is the signature ReForma nipple and works for most women. Women report that under clothes the projection is subtle and well liked, the size provides very firm hold. Recommended for areola size greater than 1.5" diameter. Actual Size: 2.25" diameter. Recommended for most skin colors. Regularly: $89.00 per pair On Sale: $39.99 per pair
Quantity		I'm Sexy Package #1 Two pairs of Medium-colored 2.25" diameter Reformas, plus a sexy fun pair of Sparkle ReForma, designed by our women's panel. One of our top sellers! (If you would like a different colored ReForma, you can specify a different color for the two pairs in the comment box at checkout.) Price: $59.99 (3 pairs)
Quantity		I'm Sexy Package #2 Two pairs of Medium-colored 2.25" diameter Reformas, plus a sexy fun pair of Sparkle Magenta, designed by our women's panel. One of our top sellers! (If you would like a different colored ReForma, you can specify a different color for the two pairs in the comment box at checkout.) Price: $59.99 (3 pairs)
Quantity		Light-Colored Nipples, Size: 2.25" Diameter The same as our signature nipple, except lighter color, with some pink. Recommended for areola size greater than 1.5" diameter. Actual Size: 2.25" diameter. Recommended for light skin. Regularly: $89.00 per pair On Sale: $39.99 per pair
Quantity		Dark-Colored Nipples, Size: 2.25" Diameter The same as our signature nipple, except darker in color. Recommended for areola size greater than 1.5" diameter. Actual Size: 2.25" diameter. Recommended for dark skin. Regularly: $89.00 per pair On Sale: $39.99 per pair
		Medium-Colored Nipples, Size: 1.5" Diameter The smaller size ReForma (1.5" diameter verses our standard 2.25" diameter) is more delicate, and has less projection (1/4" versus 3/8"). Recommended for women who insist on the smaller diameter and want to wear ReForma for occasional fashion reasons. Same great product, just smaller and more delicate. Recommended for areola size less than 1.5" diameter. Actual Size: 1.5" diameter. Recommended for most skin colors. Regularly: $89.00 per pair On Sale: $39.99 per pair This item is currently out of stock.
Quantity		Light-Colored Nipples, Size: 1.5" Diameter The smaller size ReForma (1.5" diameter verses our standard 2.25" diameter) is more delicate, and has less projection (1/4" versus 3/8"). Recommended for women who insist on the smaller diameter and want to wear ReForma for occasional fashion reasons. Same great product, just smaller and more delicate. Recommended for areola size less than 1.5" diameter. Actual Size: 1.5" diameter. Recommended for light skin. Regularly: $89.00 per pair On Sale: $39.99 per pair
		Dark-Colored Nipples, Size: 1.5" Diameter The smaller size ReForma (1.5" diameter verses our standard 2.25" diameter) is more delicate, and has less projection (1/4" versus 3/8"). Recommended for women who insist on the smaller diameter and want to wear ReForma for occasional fashion reasons. Same great product, just smaller and more delicate. Recommended for areola size less than 1.5" diameter. Actual Size: 1.5" diameter. Recommended for dark skin. Regularly: $89.00 per pair On Sale: $39.99 per pair This item is currently out of stock.
Quantity		Sparkle ReForma Same great ReForma product, but with Sparkles added! Sexy and fun, our women's panel loves them! Regularly: $89.00 per pair On Sale: $39.99 per pair
Quantity		Magenta ReForma Same great ReForma product, but Magenta-colored! Sexy and fun, our women's panel loves them! Regularly: $89.00 per pair On Sale: $39.99 per pair

550 S. Quadrille Blvd., West Palm Beach, Florida 33401 United States
Telephone: 1.561.655.3305 · Fax: 1.561.736.5288