Why radiation is a plastic surgeon's worst nightmare [Kyle Baltrusch, MD, Portland]
Radiation doesn’t just target cancer—it also damages soft tissue, making breast reconstruction much more difficult. Portland plastic surgeon Dr. Kyle Baltrusch explains the strategies surgeons use to overcome these challenges and help patients through...
Radiation doesn’t just target cancer—it also damages soft tissue, making breast reconstruction much more difficult. Portland plastic surgeon Dr. Kyle Baltrusch explains the strategies surgeons use to overcome these challenges and help patients through the process.
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Read more about Portland plastic surgeon Dr. Kyle Baltrusch
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To learn more about Dr. Kyle Baltrusch, listen to his episode of Meet The Doctor
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Where Before Meets After is a production of The Axis
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):
So you mentioned a moment ago that radiation has to happen at a certain point while the expander is in this timeline. You go from diagnosis to mastectomy first usually, and then chemo?
Dr. Baltrusch (00:21):
Depending. So patients will undergo neoadjuvant chemotherapy, meaning prior to the mastectomy, if it's indicated. And that might be because of the genetic makeup of the tumor. It could be because of the size of the tumor. So, but then, yes, there are patients that undergo chemotherapy after reconstruction as well, which then does prolong the overall reconstructive process.
Eva Sheie (00:43):
How does radiation affect the quality of the skin and your ability to make this reconstruction kind of look aesthetically normal?
Dr. Baltrusch (00:51):
Radiation is kind of the nemesis of plastic surgeons. It's very hard to reconstruct after radiation. Basically, radiation at a cellular level causes fibrosis or scarring of the soft tissues, so not just the skin, but also of the breast tissue, the fat as well. And so the blood supply as well as the lymphatic system can become scarred or fibrosis. And so after radiation, we see increased risks of wounds, infections. And so I try to do all my soft tissue reconstruction prior to radiation. So it's also why we do the oncoplastic breast reductions and breast lifts prior to radiation at the time of lumpectomy. And it's also why I want to, in my mastectomy patients get my tissue expanders to volume before radiating, because it's going to contract and scar down tissues. Radiation can take a lot of long time to recover from radiation. So reconstruction is done even many months after the completion of radiation.
Eva Sheie (01:48):
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 a production of The Axis, the podcast agency for aesthetics, theaxis.io.
Kyle Baltrusch, MD
Plastic Surgeon in Portland, Oregon
Dr. Kyle Baltrusch is not only honest, intelligent, and compassionate, but also fun, charismatic, and easy to get along with. He’s proud to be a friend to his patients just as much as their plastic surgeon.
Originally from a farming community in Montana, Dr. Baltrusch was the first in his family to attend college. With a passion for art and anatomy, he realized in middle school that he wanted to be a plastic surgeon. He landed in Portland, Oregon, for medical school and training, joined Portland Plastic Surgery Group and never looked back.
While building his own practice within a group, Dr. Baltrusch has added to his already abundant surgical knowledge. From body contouring after massive weight loss, to cosmetic breast surgery, to top surgery and breast cancer reconstruction, Dr. Baltrusch has a wide variety of patients and he loves being their biggest advocate throughout their unique journeys.
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