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Over 50 & Flourishing with Dominique Sachse

Plastic Surgeon Reveals the Truth About Breast Reconstruction & Insurance

Over 50 & Flourishing with Dominique Sachse

Dear Media

Education, Society & Culture, 3cb0e710-539e-11f0-8394-8f0cc68ecb56, Self-improvement, Health & Fitness

4.8 • 864 Ratings

🗓️ 10 November 2025

⏱️ 67 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

This week, Dominique is joined by Dr. Evan Garfein, Chief of Plastic Surgery at Montefiore Medical Center and Professor of Surgery at the Albert Einstein College of Medicine. Together, they dive into one of the most important and often overlooked conversations in women’s health: breast cancer, mastectomy, identity, and the power of choice in reconstruction.

Dr. Garfein has dedicated his career to helping women restore both their bodies and confidence after breast cancer. With more than 60 peer-reviewed publications, three biomedical patents, and nearly a decade named in New York Magazine’s Best Doctors, he is not only a surgeon but an advocate. He helped author a New York State law requiring doctors to inform women of their right to reconstruction, a crucial step toward bridging healthcare inequality.

In this episode, Dominique and Dr. Garfein discuss:

  • What inspired him to leave cardiac surgery and dedicate his life to breast reconstruction
  • How reconstruction has evolved from early muscle-flap techniques to modern options like implants and DIEP flaps
  • The emotional impact of mastectomy and why reconstruction is about more than appearance
  • The critical importance of timing, radiation, and why women must speak to a plastic surgeon early in their diagnosis
  • The hidden inequality in breast cancer care, and his fight to make reconstruction information and access a legal right for all women
  • Clarifying implant safety, longevity, and the truth behind breast implant illness and removal trends


For more on Dr. Garfein, follow him on:


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Interested in being featured as a guest? Please email ⁠⁠⁠⁠⁠⁠⁠courtney@dominiquesachse.tv⁠⁠⁠⁠⁠⁠⁠ 


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Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.


Produced by Dear Media.



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Transcript

Click on a timestamp to play from that location

0:00.0

The following podcast is a Dear Media production.

0:13.5

Today we are talking about something that affects far more women than we often realize, life after breast cancer cancer and the choices that women have when it

0:21.9

comes to reconstruction. My guest is Dr. Evan Garfine. He is a board-certified plastic and

0:27.4

reconstructive surgeon, chief of plastic surgery at Montefiore Medical Center, and co-founder of Greenwich

0:33.8

Street aesthetics in New York City. He has authored more than 60 publications, holds multiple patents, and he helped to write

0:40.9

a New York state law to improve access to breast reconstruction.

0:44.6

But what really stands out is his passion for making sure that every woman understands her

0:49.9

options, because so many don't, even though we have laws that are in existence to help.

0:55.7

So today we're going to talk about what has changed, what hasn't, and the new innovations

0:59.9

that are helping women reclaim their confidence and sense of wholeness after mastectomy.

1:05.8

Dr. Evan Garfine, so great to have you on over 50 and flourishing.

1:18.9

Dr. Garfine, it's really good to have you on over 50 and flourishing.

1:24.2

And I'm honestly so grateful that we're having this conversation, albeit, you know, sometimes sensitive in nature, but something that really needs to be discussed. I don't know

1:29.1

if you know, but I'm a retired news anchor for 30 years. And I've done a lot of stories on women who

1:35.0

have been through breast cancer, different types of breast cancer. And, you know, the conversation

1:39.5

always does lead to reconstruction. What does that look like? What the options are? And, you know, you have

1:47.5

been an advocate in this area for women. So first of all, I want to just kind of talk to you about

1:53.0

this passion of yours. And how did all of this start? Well, first of all, thanks for having me.

1:58.0

It's an honor to be on your show and to talk to your viewers.

2:02.1

It's something I am passionate about. I think it's super important. I think breast reconstruction

2:07.7

is the reason why I became a plastic surgeon. I went to residency thinking I was going to be a

2:14.6

cardiac surgeon, and that was sort of my track, and I was on a service

...

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