thanks for joining me Dr R thank you for having me yeah so you are the plastic and reconstructive surgeon here at Logan Health um I was wondering if you can just start us off with a little synopsis of what your job is yeah sure um so a little bit about my background I was actually raised in Columbia Falls um went to college in MSU and um went to uh medical school at University of Washington um I found plastic surgery there um there are a couple mentors there and I just kind of discovered the field and …

thanks for joining me Dr R thank you for having me yeah so you are the plastic and reconstructive surgeon here at Logan Health um I was wondering if you can just start us off with a little synopsis of what your job is yeah sure um so a little bit about my background I was actually raised in Columbia Falls um went to college in MSU and um went to uh medical school at University of Washington um I found plastic surgery there um there are a couple mentors there and I just kind of discovered the field and um it really appeals to me because um you just have to think creatively to solve unique problems that different patients have there's kind of no patient that's exactly the same and so that that part really appealed to me I went and did residency in plastic surgery down in Salt Lake City and then I did a one-year Fellowship in micro surgery back at udub um so my job now here is very general very broad um I have just been doing mainly reconstructive surgeries so far I haven't dipped into the Cosmetic realm yet um I may in the future uh but you know typical reconstructions that I've been doing include breast reconstruction um for patients who have cancer and require mastectomy or lumpectomy to treat for cancer um we do low extremity reconstruction and then we'll do you know different facial reconstructions uh usually for skin cancer or trauma gotcha um so I hear you're Sea Falls native is that right mhm yeah yeah how did you end up back home after moving away um I've always kind of wanted to come back um fortunately my wife Josephine was interested as well um I uh I loved the valley and uh just just a great place to raise kids I like this size Community yeah my folks are still here in colum Falls too which is a a huge benefit yeah is it uh rare to have this type of service here in the area like would people normally have to go somewhere else you weren't here yeah um so the the valley offers great plastic surgery and they have for decades um the new aspect that I bring to the table is something called micro surgery um um and I'm happy to do any form of reconstruction whether it's you know implant-based reconstruction for breast uh but something that only I would offer in the value Valley is micro surgery which is being able to transplant um tissue from one body part to a different body part on the same patient um and you know you it's a really fun surgery you get to intricately dissect blood vessels you hook them up under the microscope and you can solve some very complicated problems with this technique um I am the only microsurgeon in the state of Montana um they they do offer this form of reconstruction in bosan but they're bringing surgeons in from Texas to do it so it's it is it's a great service to offer and um prior to me starting practice here I think the patients that required it would go to places like Salt Lake City Seattle Washington that's really interesting the micro surgery when you were training to be a surgeon was that something that you had a particular interest in or was it something that was up and coming um it's been I I think the first micro surgery cases happened in the early 70s um but the way we do it today in terms of breast reconstruction um was popularized in the early 2000s um so it's relatively recent in the grand scheme of surgery I kind of discovered it during residency actually I I already knew I wanted to be plastic surgeon I really liked hand surgery um but then throughout training I I just saw the power of micro surgery and I was able to be exposed to it a lot and yeah love it so I guess you probably had a lot of the same kinds of patients that you would up here like breast reconstruction lower extremities yes yeah yep Salt Lake City is a high volume Center um they're doing uh probably three or four micro cases a week there um here you know we we'll never get to quite that volume um but we're excited to offer the service yeah so tell me a little bit about why someone might want to opt for uh micro surgery for like breast reconstruction rather than like implants or something like that sure yeah I I think both forms of reconstruction are great and some people benefit more from implants benefit from more from tissue based reconstruction um the patients who benefit most from tissue based reconstruction are patients who maybe they just want to avoid a foreign body um in their in their chest um implants can have some complications like capsular contracture which is dense scar tissue that builds around the implant and can cause pain um if implants get infected they usually have to come out it's rare for a flap or you know a pre flap which was the micro surgery reconstruction it's rare for those to get infected and then if patients require radiation as treatment for their cancer uh the flap brings like nice healthy non-radiated tissue into the area um and it just helps them heal is there any like patient stories you can share without getting into too much detail about how you've really improve somebody's quality of life because it seems like that would it would really help you know yeah uh so a lot of patients um and a lot of patients around here uh have gone through cancer um they've required radiation some of them have tried and failed implant-based reconstruction because implants fail especially in radiated patients fairly frequently um and a lot of them haven't wanted to travel to seek out options um so here uh um we've already done a few cases um in patients like this and um and it's it's patients who have you know kind of learned to live flat but always wanted reconstruction some of them have had um problems with their shoulder range of motion after radiation um and you know being able to offer a flap to these types of patients improves their um their sense of wholeness and wellbeing and um a lot of them find that after reconstruction they can kind of put the trauma of the cancer behind them on the other hand a lot of patients choose to go flat and not have reconstruction that's 100% great also for many patients yeah um so it's really it's it's treating it's treating the trauma and the sense of well-being of of patients who desire reconstruction and they're not candidates for implants occasionally and uh and the free FL is a great option for those patients yeah my boyfriend's mom had breast cancer and that's what she opted to do oh great yeah and seems to be working out great for her outside of like breast reconstruction and uh like lower extremity reconstruction what other kind of stuff do you do you run into um so I you know plastic surgery you kind of need to fill holes wherever they exist um uh recently I did a a case to reconstruct the top of somebody's thumb to avoid the thumb needing to be shortened um we were able to think of a nice little local flap option to reconstruct um so that was that's a fun case it's it's really anywhere on the body um that needs more tissue is is kind of what we specialize in we never really get into the the bowels or the internal organs uh it's it's usually skin soft tissue muscle um some bony reconstruction occasionally as well I just think it's fascinating the way that like the body can like mend itself like that do you ever find yourself just like caught up in like getting fascinated with the way Skin and Bones can heal like that especially when you take it from another part of the body like that's really interesting yeah no it's amazing it's What drew me to the field um the main thing you need to heal is a good blood supply so doing free flaps with micro surgery is bringing good blood supply to the area in addition to soft tissue to get things healed and offering a service like this to a hospital of this size empowers other surgeons to tackle problems that they might not otherwise be able to tackle um orthopedic surgeons might be capable of fixing a bone but if they don't have somebody to provide good soft tissue they might have to ship those patients out so um offering that service here in the valley keeps patients closer to home and it's it's a great thing if someone was needing something like this how does the referral process work like who do you usually work with I guess for that um the majority of my referrals come directly from Dr Captian who's the breast cancer surgeon here um but you know patients who have had mastectomies elsewhere um they might get referred from their primary care provider they could even just call and and get an appointment um a lot of my referrals end up coming from other surgeons who need my help for certain things but can also just reach out if they think they're a good candidate I'm happy to talk with them about it yeah when you guys start the plastic surgery is that how that would work as well they would just reach out yes yeah so we I think we're we're ramping up on being able to offer cosmetic quotes it hasn't quite happened yet um still fairly new to the hospital um and once that happens yeah they they can reach out and we're happy to discuss any s of any form of Aesthetic Surgery yeah I guess just one last question for you and it's kind of a softball one but tell me your favorite part about your job um I really enjoy talking with patients um you know I just like getting to know my patients and um trying to come up with solutions for them um and I and I like operating yeah a big fan of operating cool well thank you so much Dr R for doing that yeah absolutely thanks so so much for having me