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Steven Fagien, MD, FACS: His Vantage Point

By: Cathy Christensen
Posted: March 4, 2010, from the March 2010 issue of
Dr. Steven Fagien injecting a patient

Fagien specializes in only two procedures: cosmetic eyelid surgery and injectables. Photography by Steve Levine/Steady70

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“Those fields really offered something that could help people, and I always wanted to do great things and help those in severe need,” he explains. However, during his studies, Fagien found that even though he was working to accomplish good things, it didn’t always feel good, due to the obvious nature of the diseases on which he was focusing. “I asked myself what I wanted to be doing 20 years into my practice—knowing that I was going to have a family and so forth—so I made a quick decision that I probably wouldn’t pursue hematology or oncology as a profession,” he explains.

At the time, ophthalmology as a specialty piqued his interest because it offered the ability for Fagien to be both a surgeon and a medical doctor. Although he considered specializing in plastic surgery, he wasn’t initially committed to it as a field. “Ophthalmology gave me the luxury of doing several things, and then I could pick and choose and subspecialize. In the middle of training, I realized I really didn’t want to be an eye surgeon. I couldn’t see doing cataract surgery for the rest of my life,” says Fagien.

At this time one of his mentors, Melvin Rubin, MD, suggested oculoplastics as a career. It was late in the year when Fagien decided to pursue oculoplastics, and many schools had already decided on fellows, but when doing his research about which universities offered the best programs, Fagien found the University of Illinois Eye and Ear Infirmary in Chicago was a leader. A last-minute trip to the Windy City in order to grab the attention of Allen Putterman, MD, paid off, with Putterman giving Fagien the nod to start his experience in Chicago. After a rigorous fellowship where Fagien was the only oculoplastics fellow in the city, he was recruited by a group of physicians in Florida and decided to return to a warmer climate, with his degree in hand.

During his first years in the field, Fagien worked to figure out what he really wanted to focus on in oculoplastics. “I started doing a lot of reconstructive surgery, trauma and cancer cases, and enjoyed it. When I entered private practice and moved to Boca Raton, people were coming to me saying they were interested in having their eyes done by a guy who was trained in ophthalmology. It’s a fairly affluent population and many are of an age where they are interested in having cosmetic surgery,” says Fagien. “And the more I did cosmetic surgery, the more I loved it. I got that feeling that ... I wasn’t saving the world ... but I was helping patients who weren’t happy with their appearances leave my office thinking they looked pretty darned good.”

Soon, Fagien found himself receiving invitations to speak at national meetings, and plastic surgeons who had seen his work were inviting him to speak at events. He developed several procedures in cosmetic oculoplastic surgery that have become standard, and now specializes only in cosmetic eyelid surgery and injectables.