May 13, 2011 – Dr. Steven Fagien will never forget 2-year-old Joshua, a South Florida boy who was born without eyelids. It was 1998 and a rare genetic condition, with only a handful of known cases worldwide, left the toddler’s eyes unprotected.
Although it was a challenging case for the Boca Raton oculoplastic cosmetic surgeon, Fagien donated his services and operated for three hours, using a variety of reconstructive procedures to successfully create eyelids for the child.
The surgery helped relieve Joshua’s eye dryness and pain and markedly improved his appearance. Fagien has stayed in touch over the years with Joshua and his family, and Joshua, now a young man, is doing extremely well, Fagien says.
Joshua’s surgery and hundreds more like them are what attracted Fagien, a 1983 graduate from the UF College of Medicine, to the specialty almost 30 years ago. Throughout his career, he has performed reconstructive surgery on children in the U.S. and Central America, built a successful private solo practice in Boca Raton and now travels internationally to speak as an expert on cosmetic eye surgery and injectable agents, such as Botox.
He also has written numerous articles and a best-selling textbook on oculoplastics, developed new oculoplastic surgical procedures and has served as a consultant for national companies, such as Allergan. And it was UF, he says, that provided the foundation of core knowledge and ethical principles that would guide him as a physician.
Growing up in Hollywood, Fla., Fagien, 54, and his identical twin brother, Michael, a South Florida radiologist and 1986 UF COM graduate, decided early on to become physicians. Steven Fagien spent 13 years at UF, first earning a bachelor’s degree in chemistry, then attending medical school and finally completing a residency in ophthalmology.
“It was a great experience – actually I didn’t want to leave,” he said. “I’m very proud to say I graduated from UF.”
UF was where he met mentors – like ophthalmology professor Mel Rubin, M.D., and the late dean of students Hugh M. “Smiley” Hill, M.D. – who had a great impact on his personal and educational growth.
“It started from a basis of being honest and doing the right thing,” he said. “The qualities I saw in the (UF) faculty, they passed onto their students.”
Hill was a physician who taught his students so much about medicine and life in general, including the importance of ethics and being genuine, Fagien said.
“He was one of those individuals who cared very much about every student and had the uncanny ability to remember everything about you,” he said. “(And) he really drove home that all you really have at the end of the day is your honesty and integrity.”
Rubin, another one of Fagien’s heroes, helped him choose a subspecialty and land a top-notch fellowship at the last minute.
“Mel took a chance on me, even when he chose me to be one of his ophthalmology residents because I was definitely a different type of applicant,” he said.
Fagien chose ophthalmology because it allowed him to be both a surgeon and medical doctor, but he wasn’t sure which subspecialty to pursue. He struggled with deciding to do a plastic surgery fellowship and settled on it late, when most of the positions were already full.
Rubin who agreed that oculoplastic surgery was a great choice for Fagien, called his colleague, Dr. Allen Putterman, who ran one of the country’s top programs in Chicago but had already interviewed dozens of potential fellowship candidates and believed he had already chosen one. Dr Rubin asked him to consider Fagien for an oculoplastics fellowship at the University of Illinois Eye and Ear Infirmary in Chicago. Putterman agreed only if Fagien flew up that day for an interview.
“For some reason we immediately bonded and he picked me,” said Fagien with a smile. “So for this and many other reasons, I’m forever indebted to Mel.”
Putterman also became one of his mentors, friend, and valued colleague asking Fagien to eventually take over as author of the newest edition of his best-selling textbook, “Putterman’s Cosmetic Oculoplastic Surgery.” Detailing cosmetic oculoplastic and oculofacial techniques for physicians, the book is distributed worldwide and printed in four languages and continues to be a best-seller in both ophthalmology and plastic surgery.
Fagien said he seriously considered returning to Gainesville and the UF College of Medicine as an oculoplastic surgery faculty member. His wife Debra, his high school sweetheart who he married his second year of medical school, worked as an accountant in Gainesville and the couple loved the area.
But they ultimately chose to return to South Florida to be near family, and Fagien joined a multispecialty group practice in 1988 in Boca Raton. From the time he started his private practice, he wanted to help others less fortunate and began volunteering to help an eye clinic for migrant farm workers in West Palm Beach.
“It really made me feel good to do that, but I wanted more,” he said.
Fagien and another oculoplastic surgeon in South Florida were both interested in doing work in impoverished areas including Mexico and Central America with the non-profit humanitarian organization, Surgical Eye Expeditions International. Specifically, they wanted to do eyelid and orbital surgery reconstruction, which no aid groups were doing. They traveled to remote, rural areas in Mexico and El Salvador to reach patients in need of the surgery, many of whom were children.
“In many cultures, particular in Third World countries, if a child has a facial deformity, he or she is forever an outcast,” he said “Being able to make a big difference in their life by reconstructive surgery was probably the most professionally gratifying thing I’ve ever done.”
But Fagien eventually had to stop some of the trips as travel in particular regions became too dangerous. He established a solo practice in 1995, and he and his wife focused on raising their three daughters. Samantha, 21, is now a student at the University of Michigan, Alyssa, 19, attends UF and Kayla, 14, is in high school. Fagien concedes that despite all of his professional accomplishments, raising his girls has been his greatest pleasure and his proudest personal reward.
Fagien has embraced new technology throughout his career, becoming especially interested in the latest developments involving injectables, like Botox collagen and other facial filling agents. In the 1990s, he started Collagenesis Inc., a company that explored injectable alternatives and commercialized several products in plastic surgery and dermatology. He also has served as a consultant and medical adviser for several national and international companies, such as Allergan, Johnson & Johnson and Sanofi-aventis.
“I’ve always been fascinated by things that are new and exciting,” he said. “I think I like to take things to the next level.”
Fagien also has developed many new surgical techniques, which he said he continues to evolve.
But he admits he’s a little old-fashioned when it comes to medical training and principles. Fagien said he thinks it’s more important than ever for medical students to not try to rush through their studies and get distracted by all the gadgets and technology that surround them. “Technology is necessary, wonderful and in many ways advances medicine, but this will never replace exceptional core knowledge, good judgment and common sense,” he says.
“One of the things I learned in Gainesville is to really enjoy your surroundings and learn,” he said. “I think back to my time at the University of Florida… (and I feel like) what a gift.”