This week, we’re talking all about Portrait and the aesthetics industry with San Francisco Bay Area-based Medical Director, James Newman, MD, FACS.
Portrait: Hi Dr. Newman! It’s such a pleasure talking to you today. Would you mind introducing yourself?
Dr. Newman: I’m Dr. James Newman. I'm a board-certified facial plastic surgeon. I’ve been practicing in the San Francisco Bay area for just about 20 years. I was on faculty at Stanford University for ten years, then founded my own practice, Premier Plastic Surgery, where we have a multidisciplinary team of doctors and nurses. I have two plastic surgeons and one oculoplastic surgeon on my team, as well as a dermatologist. We also have estheticians and nurses on our team, allowing us to bring surgical, non-invasive, and minimally invasive treatments, plus skincare all under one roof. We have four locations along the coast: Palo Alto, San Mateo, Los Gatos, and Half Moon Bay.
Portrait: Tell me a little bit about your career path—how did you get into the medical field and what drew you to plastic surgery?
Dr. Newman: I’ve always had an interest in Biology—my father was an ophthalmologist and so I always liked science. I went to school in Texas at Baylor University and then decided to pursue a medical career at the University of Texas Medical Branch. I did a lot of research in neurosciences and initially planned on going into neurosurgery.
When I got into the clinical portion of my education, I realized neurosurgery wasn’t for me. I was missing that level of patient connection post-surgery where you’re able to talk to the patient. I had done a lot of cases with plastic surgery and enjoyed interacting with patients before and after surgery. So, I decided to transition into plastics, where I focused mostly on facial plastic surgery.
I did my internship and residency at Stanford University at a time when new technologies were just coming to plastic surgery. For example, the use of a CO2 laser and even botulinum toxin was not FDA-approved at the time. It wasn’t until 2004, when it was approved for cosmetic uses, that it just exploded out on the West Coast. I was able to experience the beginnings of all that.
I also published a lot of papers on the use of energy-based systems to help the skin, whether it’s microneedling with radio frequency or CO2 lasers. More specifically, publishing writings on how to combine some of these less invasive techniques with our standard surgical procedures to really benefit patients. So, my journey into aesthetics was kind of a natural progression.
I had an opportunity in 2000 to create a private practice of my own. Doing so really propelled us to be at the forefront of minimally invasive facial plastic surgery. At the time, plastic surgeons and dermatologists remained very separate, but it was my goal to bring them together. I recognized the value that skincare has for patients, both for post-surgery and for overal wellness. We partnered with a couple of high-end, well-experienced estheticians, along with other specialized professionals, so that patients could get expert opinions on a variety of concerns all under one practice. Here we are 22 years later: Premier Plastic Surgery has four offices, 17 employees, and five different doctors that work with us.
Portrait: How have you seen the industry evolve throughout your career?
Dr. Newman: When I first started, there was basically BotoxⓇ and then something called Zyderm, which is a bovine collagen that was actually developed in Palo Alto. RestylaneⓇ was the first hyaluronic gel filler that came from Sweden in the early 2000s, which really expanded the duration of effect, and fillers just really took off from there. We used to look to our European colleagues who would have maybe 20 different choices of fillers, while here in the United States we only had one or two. Now, we are in a situation where we are using the best products available that are clinically proven both for safety and efficacy. There are always going to be new products and treatments coming about, so continued education is very important and something we stress with our nurses. Even though the better products available today result in less reactions and risk, proper training is critical.
Portrait: How has your practice changed in Silicon Valley over the last 20 years?
Dr. Newman: Generally, what we’re seeing is that patients don’t have the downtime to take a couple of weeks or months off to have their traditional surgeries. So, we’ve had to modify things a bit, which is where the introduction of these minimally invasive technologies come into play. For example, about 15 years ago, we were the first to do studies on Thermage, a non-invasive radiofrequency therapy that enhances collagen production without cutting the skin. Silicon Valley folks love the idea of getting some improvements through combinations of smaller treatments on a more routine basis without experiencing any downtime. There is a ton of growth right now in the non-invasive treatments: For every big facelift that I do, there are probably ten patients that receive non-surgical treatments, anything from injectable filler to microneedling. Over the years, we’ve also shifted to focus more on overall wellness—looking at how you can keep the inner body healthy using treatments like vitamin micronutrient therapy. I suspect that this trend will continue.
Portrait: What has been most impactful on your success in the industry?
Dr. Newman: I think the biggest factor in our success has been learning from and being able to empathize with our patients. I really listen to what their goals are and create new concepts that will yield the results they’re looking for. The fun part about medicine is that it’s both an art and a science. Sometimes you combine things serendipitously and then you learn from each patient situation. There are so many tools that we have at our hands, so we’re able to assess the patient and then offer combination therapies that can get them phenomenal, natural results. This effort makes our practice stand out and is why a lot of patients will travel from different areas to receive treatment. Patients come to us when they want something safe and long-lasting. Our practice motto is “aesthetics and wellness, for life” and we really mean that. We’re not trying to get patients in and out—we want them to develop a relationship with our team for the long term.
Portrait: How can aesthetic medical providers new to the field best perfect their craft?
Dr. Newman: It really takes two-to-three years to become comfortable as an injector. I encourage new injectors to attend conferences, shadow more experienced injectors and practice on friends and family. As you go, you will learn little pearls of wisdom from each of these experiences that will help you become a better injector overall. If you want to improve your skills, you have to be a real critic of yourself. Don’t be afraid to put in the extra effort to get feedback from patients, because it will only make you better over time.
Portrait: What attracted you to working with the Portrait community?
Dr. Newman: I was most impressed with the work that Dr. Blake has done to standardize training and implement processes to allow everyone to operate on the same page. I know from experience that this takes a tremendous amount of work. Combining that with CEO Praveen’s technology background, plus software that allows you to accurately store and analyze patient data gives Portrait the potential to become a really impactful brand. Portrait is positioned in a way to have well-trained individuals who can deliver good service and do it safely. I’m happy to serve as the medical director in this area so that if there are any issues, we can jump right in and ensure that patients are taken care of.
Portrait: Are there any new products or procedures you’re excited about?
Dr. Newman: I’m excited about some of the new fillers that are coming out—including hybrid fillers and stretchier, elastin-based fillers. I’m also looking forward to many advancements in regenerative medicine and combining patient tissue with different products in treatments like PRF for hair growth. There is a new laser called Avaclear that was just approved by the FDA in early May that can cure acne with just three treatments, so you’ll be hearing about that as well.
Portrait: What role do you see technology playing in the future of patient engagement and the growth of your business?
Dr. Newman: Operating through COVID-19 has taught us that we can have a pretty good conversation with a patient and do some facial analysis without them having to come into the office. This can form the groundwork for what the patient should consider treatment-wise and can be very efficient. You can screen patients through 15-minute virtual consultations without them having to leave the comfort of their home. In this session, the provider can give them an idea of treatments that they may benefit most from. This allows providers to deliver more efficient care and when the patient does eventually take a trip to the office, a treatment plan is already in place. It also increases patient satisfaction because post-treatment we can do virtual check-ins on a more frequent basis to ensure recovery is going as planned.