Dr. Baltrusch (00:00):
My name is Kyle Baltrusch. I am a plastic surgeon at Portland Plastic Surgery Group in Portland, Oregon.

Eva Sheie (00:05):
How do your patients find you?

Dr. Baltrusch (00:07):
My patients find me through my surgical oncologist. So I work very closely with a group at Legacy, and I honestly feel very blessed to work with these women. They are five powerhouse women. I work mostly with three of them. I trained under them, so I was a resident. And then I got to work with them many years ago and during my training, and then luckily came out and joined this practice and this practice was already very well established with them. Our schedulers are twin sisters, so the scheduler for the surgical oncology office, her twin sister's my scheduler, and so our patients are pretty glued in from the beginning. But yes, I work with mostly three breast surgeons at Legacy who are very big advocates for their patients. And I honestly think that they're some of the most badass women in reconstruction. They've had breast cancer themselves, two of them. And so they can really relate with their patients, and I just find them amazing women. So they basically refer patients to me. They kind of know my personality, and this is a very personal subject for a lot of women. And so if they feel like I'm a good fit as their reconstructive surgeon, then they're going to refer them over to me. If they feel that they're in better suited in someone else's hands and they're going to refer them to another reconstructive surgeon. But I find that I love the patients that they send me.

Eva Sheie (01:28):
If you had to guess, or if you know, how many people have you helped over the years?

Dr. Baltrusch (01:34):
So I just started my fourth year here at Portland Plastic Surgery. I would venture that it has to be 200 or plus. So breast cancer is about 30, 40% of my practice, and I'm doing oncologic procedures weekly. I'm at the hospital with those surgeons on a weekly basis, performing surgeries.

Eva Sheie (01:56):
Do you like going to the hospital?

Dr. Baltrusch (01:57):
I do. We get to work with the same team. So I have my PA, they have their PA, we work side by side at the table together. And it's always nice to catch up with the surgical oncologists and kind of banter and chat. And we also, it gives us face-to-face time where we do get to talk about patients as well and what we think is best suited or indicated for our patients.

Eva Sheie (02:18):
I think people would be surprised to find out how much communication the doctors have, that team of doctors has,, about every patient that you're constantly following them and caring about what's happening.

Dr. Baltrusch (02:31):
Yeah, certainly. One thing that I'm not as involved in is they have a multidisciplinary meeting every Tuesday morning where they discuss all the breast cancer patients. So they sit down with the radiologist, the surgical oncologists, the medical oncologists, and they review all the imaging, genetic makeup. So there's a pathologist that's reviewing slides and they discuss basically next best options for each patient. That usually happens before I even meet patients, and that's why I say that they kind of come to me already with an idea of what their options are and what's been discussed or what the surgical oncologists feel is best for their patients.

Eva Sheie (03:09):
Genetic testing has also become much more common and recommended and very important in recent years. Is there information that you get from the genetic testing that you can actually use?

Dr. Baltrusch (03:22):
So usually because we are catching cancer at a much younger age, we're starting to see more women in their thirties and forties. And so I think a lot of women are more interested in genetic testing because they have to think about their families. And so certainly if a patient is like a BRCA carrier that does guide reconstruction, they're more likely going to undergo bilateral mastectomies, but it's also future family planning. So women have to potentially harvest eggs because they recommended having a hysterectomy. And so I think we are seeing an increase in genetic testing and it's, I think for those reasons it does certainly help guide reconstruction. I think if women know that they are genetic, they have a gene mutation like BRCA or CHEK that they're going to be more inclined to undergo mastectomies.

Eva Sheie (04:15):
On this podcast, we bring you directly to the doctors who are where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. Where Before Meets After is the production of The Axis, the podcast agency for aesthetics, theaxis.io.