Reconstructive plastic surgeon at NYU Langone Dr. Oriana Cohen and one of her patients share important insights about breast reconstruction.
Breast reconstruction is a vital aspect of recovery for many women facing breast cancer. At NYU Langone, plastic surgeon Dr. Oriana Cohen and her team in the Hansjörg Wyss Department of Plastic Surgery offer a compassionate, comprehensive approach to help patients regain their sense of self after surgery.
“Breast reconstruction is a field within plastic surgery where an aesthetic outcome is paramount in the restoration of form and function,” Dr. Cohen says. “Equally important is providing patients who choose reconstruction the confidence of a renewed sense of self. I am devoted to helping patients feel comfortable and happy with themselves.”
Read on to learn Dr. Cohen’s insights about breast reconstruction and the options available at NYU Langone.
Dr. Oriana Cohen, MD, is aclinical assistant professor at Hansjorg Wyss Department of Plastic Surgery at NYU Grossman School of Medicine and associate director of the plastic surgery residency and Fellowship Programs at NYU Langone.
Modern Luxury: Can you share the breast reconstruction options available for patients at NYU Langone?
Dr. Oriana Cohen: “Patients undergoing lumpectomy may be candidates for plastic surgery, which could involve closing the breast in a layered fashion, rearranging the breast tissue to fill the area where breast tissue was removed, or performing a breast reduction at the time of a lumpectomy. Alternatively, in patients undergoing mastectomy, reconstruction falls under two main categories: implant-based reconstruction and autologous reconstruction. Implant-based reconstruction involves the use of saline or silicone implants to fill the breast pocket. Autologous reconstruction utilizes your own tissue to reconstruct the breasts.”
ML: With so many different options, what factors do you consider when recommending a specific technique to a patient seeking reconstruction?
Dr. Cohen: “The reconstructive options center around both patient preference and surgeon recommendations. Some women choose implant-based reconstruction, given the shorter recovery times associated with that option and the fact that an additional surgical site is not needed. Patients whose cancer treatment plan requires radiation after surgery may be better suited for autologous reconstruction. We have many surgical approaches and options that can be tailored to the individual patient in terms of reconstructive goals and patient preference.”
ML: Can you share any recent innovations in breast reconstruction and how they benefit patients?
Dr. Cohen: “More and more patients are undergoing a procedure called prepectoral breast reconstruction, which allows for reconstruction above the pectoralis major muscle, resulting in less postoperative discomfort, faster recovery, and less disruption of the chest muscles. Direct-to-implant reconstruction has also gained popularity in certain patients, I can place the breast implant on the same day as the mastectomy, which eliminates the traditional two-stage approach to implant placement, thereby improving recovery time and potentially eliminating the need for an additional surgery. Another innovation in breast reconstruction is neurotized breast reconstruction, which allows for nerve reconstruction during surgery to improve sensation in the breast following mastectomy."
ML: There are a lot of factors to consider when it comes to breast reconstruction. How do you help educate your patients on the risks and benefits of different procedures?
Dr. Cohen: “Patient education is a crucial part of my practice at NYU Langone. During the initial consultation, I thoroughly review risks and benefits of the various reconstructive approaches to ensure every patient is able to make an informed surgical decision. Some patients worry about implant safety—I make sure to answer their questions and provide supporting literature so they can be fully informed about implants. Patients also ask about the number of reconstructive procedures, which can vary from patient to patient. It’s also important that patients know that if they choose autologous reconstruction, they will have an additional surgical area to heal and the complications associated with that.”
ML: Navigating the reconstructive process can be emotional and overwhelming. How do you and your NYU Langone team support patients throughout the process?
Dr. Cohen: “My team is here for patients throughout the reconstructive process, from initial consultation to final surgery. We can address patients’ concerns in person, via phone or telemedicine, or using our messaging application. We also have access to patient support groups and social work through NYU Langone’s Laura and Isaac Perlmutter Cancer Center, including groups that can help inform a patient’s decision-making process.”
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We also spoke with one of Dr. Cohen’s patients, Alison Gore to learn about her breast reconstruction experience at NYU Langone. When a 2022 biopsy confirmed Gore had invasive ductal carcinoma, she was guided through several additional biopsies and screenings before consulting with a breast surgeon and deciding on a bilateral mastectomy and DIEP flap reconstruction surgery.
Modern Luxury: How did you decide on a breast reconstruction technique that felt right for you?
Alison Gore: “This is a very personal decision that involved research, surgical consultations and speaking with friends and family. One of those consultations was with Dr. Cohen. After speaking with her and learning about the procedure in as much detail as I could understand, we booked the surgery. I felt more comfortable with DIEP flap reconstruction done at the same time as the bilateral mastectomy, even though this involves more extensive preparation and longer surgery.”
ML: How did you choose NYU Langone for your breast reconstruction, and what stood out to you about Dr. Cohen and her team?
Gore: “I have always trusted NYU with my health over the years, I am comfortable with and confident in NYU Langone. Upon diagnosis, I first called my gynecologist. She highly recommended my breast surgeon, Dr. Axelrod. We talked about several plastic surgeons with excellent credentials, and I chose Dr. Cohen. I really liked her immediately—a first impression of warmth, experience and confidence. She has a really positive energy about her and took all the time I needed to walk through big questions, silly questions, anything. Dr. Cohen explained everything so clearly and helped me wrap my mind around this extremely involved surgery. With the education and explanation detailed in my notes, I was calmer and clearer to proceed.”
ML: Can you describe the impact of breast reconstruction on your physical and emotional well-being post-surgery?
Gore: “Breast reconstruction on the same day as my mastectomy helped me begin to put a stressful and overwhelming health issue behind me more quickly. There are many paths women can take along this journey of breast cancer and all of them are unique. Reconstruction and the recovery that followed allowed me to start moving and feeling like myself again. After the surgery, I was very focused on walking as much as possible—I set a goal to run a Thanksgiving “Turkey Trot.” I wanted to get back to being a mother, watching kids’ sporting events and being involved in their lives. While this can be truly overwhelming for anyone to experience, the team at NYU did help the scars fade along with the emotional distress associated with breast cancer.”
Alison Gore skiing four months post-operation.
ML: What advice would you give to other women facing a similar diagnosis and considering reconstruction? What resources or support systems did you find most helpful?
Gore: “Get involved with researching your options and understand what’s possible. I had a difficult time making a decision around reconstruction and ultimately put myself into the hands of doctors that I felt most comfortable with during consultations and conversations. I wanted to be as prepared and knowledgeable as possible so I could have an intelligent conversation around reconstruction; I believe it can lead you to a more precise decision for your own steps toward healing.”
Learn more about the Hansjörg Wyss Department of Plastic Surgery and NYU Langone.
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