Question 16603 — maternity health insurance

Summary

Mr. Thierry Perez draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the progress of the discussions undertaken concerning the recognition and management of the definitive three-dimensional tattoo of the areola-nipple plaque after breast cancer. In its response published on June 10, 2025 to written question no. 805 from Ms. Laure Lavalette, the ministry recalled that the reconstruction areola-nipple could be carried out surgically or by medical dermopigmentation and that only medical tattooing, carried out by a trained health professional, was then covered by health insurance. The ministry also indicated that professional tattooists had developed an artistic technique of 3D trompe l'oeil tattooing to reconstruct the nipple, while considering that it was not desirable, at this stage, to extend coverage to tattoos performed in non-authorized structures by tattooists who have not received medical training. However, this same response specified that, within the framework of the ten-year strategy to combat cancer and the objective aimed at limiting the after-effects and improving the quality of life, "reflections are thus underway on the possibility of recognizing the performance of this act to other categories of paramedical professionals”. Almost a year after this response, he therefore wishes to know where these reflections stand and what concrete follow-up the Government intends to give them. Reconstruction of the nipple-areola plate constitutes, for many women who have undergone a mastectomy, an essential step in their physical, psychological and intimate reconstruction. 3D artistic tattoo allows, thanks to drawing work, colorimetry, shadows and lights, to obtain a personalized and realistic result, likely to meet the expectations of certain patients who do not wish to resort to a new surgical procedure. However, this artistic dimension does not always fall within the core business of surgeons. These are above all trained and mobilized for medical and surgical procedures, in a context of tension hospital and sometimes significant delays in accessing care. It could therefore be useful to consider a device to relieve surgeons of this mission when it is mainly an aesthetic and artistic gesture, while guaranteeing a high level of health safety. Such a development would also make it possible to recognize the know-how of professionals specializing in 3D artistic tattooing, their open a secure intervention framework and give more choice to patients. The objective would not be to oppose surgical reconstruction, medical dermopigmentation and 3D artistic tattooing, but to allow each patient, in conjunction with their medical team, to choose the solution best suited to their journey, their body and their expectations. To this end, a national framework could be considered, based for example on compulsory additional training, health clearance, reinforced hygiene rules, prior orientation by a health professional, as well as an agreement with health insurance or with health establishments. This system could include, where appropriate, certain paramedical professionals but also specially trained and authorized professional tattooists, as long as they respond to strict criteria for competence, safety and patient monitoring. Also, he asks him to specify the progress of the reflections announced in the ministerial response of June 10, 2025, the timetable envisaged for their conclusions, as well as the measures that the Government intends to take to allow the secure realization and possibly support of the definitive three-dimensional tattoo of the areola-nipple plate by specifically trained professionals. He also asks if the Government plans to open this reflection to specialized professional tattooists, in order to relieve surgeons of this mission with a strong artistic dimension, to recognize the skills of these professionals and to offer patients a wider choice in their reconstruction process after breast cancer.

Machine translation from French. The official text remains authoritative.

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